Endometriosis: The Silent Struggle of Adolescents and theUrgent Need for Early Diagnosis

Adolescents tell us, but we don’t listen.

Endometriosis is a hidden, progressive disease that demands attention from parents, friends, colleagues, and relatives—compassion alone is not enough. This condition manifests between menarche and menopause and is a chronic, benign, estrogen-dependent, progesterone-

resistant inflammatory disease. Nearly 1G2 million women worldwide and 30 million in India suffer from endometriosis. It is a major cause of subfertility and long-lasting pain, with both genital and extra-genital symptoms.

Adolescence is a time of major physical changes and social transitions. It is a stage where young individuals develop their identity, make informed choices, and shape their future careers. Menarche marks the beginning of menstrual cycles, often accompanied by pain and hormonal fluctuations that follow a cyclical pattern.

Every case of endometriosis starts somewhere—typically at stage one—and progresses

silently. Most girls begin menstruating around ages 13-14, and during these formative years, symptoms of endometriosis may emerge. However, since routine tests often fail to detect the disease at this stage, their pain is overlooked, and they continue to suffer without a definitive diagnosis. By the time they reach their early 20s, the disease can take one of several aggressive paths.

This is a challenging time for adolescents who repeatedly express their distress over severe menstrual pain to parents, teachers, friends, and colleagues. Each month, the pain returns— intensifying, relentless, and overwhelming—turning their periods into a recurring nightmare. Yet, instead of receiving proper medical attention, these young individuals are frequently dismissed and told that “period pain is normal,” leaving their suffering unnoticed and unaddressed.

After an average of 5 to 10 visits to multiple specialists and a diagnosis delay of 6 to 8 years, many patients remain undiagnosed while their pain worsens to unbearable levels. By the time they receive answers, they are often physically and emotionally exhausted, feeling hopeless and trapped in their suffering. Who is at fault?

We are all responsible for this delay in diagnosis because of the persistent myths surrounding endometriosis:

1. Endometriosis in teenagers is always mild and does not
2. Endometriosis is rare in adolescents, so there is no need for early
3. Endometriosis usually disappears on its own or improves in late

These misconceptions prevent timely diagnosis and treatment, allowing the disease to advance unchecked.

Studies and Research

• According to a survey by the Japanese Endometriosis Association, 80% of patients with a confirmed diagnosis of endometriosis retrospectively experienced menstrual pain, backache, dyspareunia, and dyschezia. Additionally, half of these patients reported infertility.

• Research indicates that 50% to G0% of girls experience dysmenorrhea, with 20% to 25% suffering from severe pain.
• A study by ANZJOG found that 65% of participants had dysmenorrhea, with 27% experiencing severe pain that interfered with daily activities.

Solutions: The Urgent Need for Early Diagnosis

Early diagnosis is the key to managing endometriosis and preventing its severe consequences.

Innovative Diagnostic Approaches

• The salivary test developed by Ziwig now enables the early detection of

endometriosis. This non-invasive, simple test allows for timely medical intervention and can help prevent disease progression.

The Importance of Ultrasound and MRI

• Diagnostic tools like ultrasound and MRI can help detect endometriosis early and enable timely
• A simple ultrasound can identify ovarian cysts, endometriomas, and adhesions.
• MRI can accurately detect bowel or bladder endometriosis and nerve root compression, providing greater clarity in complex

Tailored Treatment Options

• Endometriosis treatment must be customized according to the stage of the
• Medical therapies can prevent progression, while laparoscopic surgery can reduce pain and improve fertility.
• Early diagnosis helps prevent the chronic pain cycle, where repeated nerve pain

leads to central sensitization, making complete pain relief difficult even after surgery.

Preventing Severe Complications

• In advanced cases with bladder or bowel involvement, laparoscopic excision surgeries are often
• Early intervention reduces the need for repeat surgeries and minimizes the risk of infertility and recurrence.

Raising Awareness and Taking Action

By spreading awareness, improving diagnosis, and taking action, we can change the lives of millions of women suffering from this silent disease.

Let’s make March an Endometriosis Awareness Month—wear yellow to show your support

and help bring this hidden disease into the spotlight. Together, we can make a difference.