Endometriosis and pain in the adolescent- striking early to limit suffering: A narrative review

Neurosci Biobehav Rev. 2020 Jan:108:866-876. doi: 10.1016/j.neubiorev.2019.12.004. Epub 2019 Dec 17.


Endometriosis, a condition in which uterine tissue grows outside the uterus, is a debilitating disease, affecting millions of women and costing the United States approximately $78 billion annually in pain- related disability. It is also the leading cause of chronic pelvic pain (CPP), which is often unresponsive to existing treatments. Adolescent women with the disease are at particular risk as there are often significant diagnostic delays, which in turn can exacerbate pain. Research and treatment guidelines for adolescents with endometriosis are largely based on studies for adult women due to the limited number of studies focusing on adolescents. The current paper critically reviews the literature as it pertains to endometriosis pathophysiology, mechanisms contributing to CPP, and treatment implications and recommendations with a focus on gaps related to adolescents.

Keywords: Adolescence; Brain; Chronic pelvic pain; Endometriosis; Inflammation; Nerve; Psychology; Treatment.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Review

MeSH terms

  • Adolescent
  • Animals
  • Chronic Pain* / diagnosis
  • Chronic Pain* / drug therapy
  • Chronic Pain* / etiology
  • Chronic Pain* / physiopathology
  • Endometriosis* / complications
  • Endometriosis* / diagnosis
  • Endometriosis* / drug therapy
  • Endometriosis* / physiopathology
  • Female
  • Humans
  • Pelvic Pain* / diagnosis
  • Pelvic Pain* / drug therapy
  • Pelvic Pain* / etiology
  • Pelvic Pain* / physiopathology