Interview has been edited for clarity.
Dr. Zondervan says that, historically, clinicians have assumed that teenagers can’t have endometriosis, simply because there was so little evidence out there to suggest otherwise. Now we know that is not true.
“When teenagers start having periods, they may have something called primary dysmenorrhea, which is first onset period pain that goes away and is not related to endometriosis or other conditions at all. So there’s potential for confusion here.”
She says that if you’re a teen with really excessive pain during your periods, that should be looked at, and it shouldn't be considered normal, but the chances that it is due to endometriosis are relatively small.
Dr. Zondervan says that one of the things that clinicians rightly do not want to do is immediately start surgical interventions in young teenagers. “Whenever you have a surgery, it is not without potential complications. Laparoscopy is done under a general anesthetic, and also every time you do surgery, there is a healing process that can cause adhesions, and so on. It is not something that you undertake lightly.”
She says that many treating physicians prefer to first see whether hormones help. Oral contraceptives are the first thing to try, and they work for many teenagers.
“But if someone has persistent problems, or if contraceptives do not work, or if they cause lots of undesirable side effects, I think it is really important to tell your physician and ask what other options are available.”