TY - JOUR
T1 - Delayed diagnosis and treatment of adolescents and young women with suspected endometriosis
AU - Beloshevski, Boris
AU - Shimshy-Kramer, Miriam
AU - Yekutiel, Matar
AU - Levinsohn-Tavor, Orna
AU - Eisenberg, Neta
AU - Smorgick, Noam
N1 - Publisher Copyright:
© 2024 Elsevier Masson SAS
PY - 2024/3
Y1 - 2024/3
N2 - Study objective: Early diagnosis and treatment of endometriosis in adolescents and young women is considered essential for improving their quality of life and for prevention of long-term complications. In adult women with endometriosis, significant delays in diagnosis and medical or surgical treatment have been described. Our study aimed to investigate the delay in diagnosis and treatment of adolescents and young women with suspected endometriosis. Methods: A retrospective study of adolescents and young women (12–22 years-old) who were evaluated for suspected endometriosis at the endometriosis clinic in the Shamir medical center between January 2017 and December 2022. All patients were referred by their primary care gynecologists. The evaluation in the endometriosis clinic included targeted history, physical exam and a focused ultrasound survey for endometriosis (performed trans-abdominally in all cases, and trans-vaginally in sexually active women). Results: Out of 400 women with suspected endometriosis evaluated in our endometriosis clinic during the study period, 68 were adolescents and young women <22 years old. Their mean age at time of evaluation for endometriosis was 18 ± 2.5 years, and the mean time-period from onset of symptoms to the endometriosis evaluation was 4.0 ± 2.9 years. Their most common symptoms were dysmenorrhea (in 61 cases, 89.7 %), followed by gastrointestinal symptoms (in 32 cases, 47.1 %). In 30 (44.1 %) cases, hormonal treatment was prescribed by the primary care gynecologist prior to their appointment in the endometriosis clinic. On comparison of patients with delay of <4 years (N = 31) versus ≥4 years (N = 37) from symptom onset to the endometriosis evaluation, patients with shorter duration of symptoms were more likely to decline any hormonal treatment for endometriosis while patients with longer duration of symptoms were more likely to accept the recommendation for hormonal treatment (16.2 % versus 0 %, p = 0.02, and 83.8 % versus 100 %, p = 0.03, respectively). Conclusion: Adolescents and young women with suspected endometriosis may experience significant delays in diagnosis and medical care, similar to adult patients.
AB - Study objective: Early diagnosis and treatment of endometriosis in adolescents and young women is considered essential for improving their quality of life and for prevention of long-term complications. In adult women with endometriosis, significant delays in diagnosis and medical or surgical treatment have been described. Our study aimed to investigate the delay in diagnosis and treatment of adolescents and young women with suspected endometriosis. Methods: A retrospective study of adolescents and young women (12–22 years-old) who were evaluated for suspected endometriosis at the endometriosis clinic in the Shamir medical center between January 2017 and December 2022. All patients were referred by their primary care gynecologists. The evaluation in the endometriosis clinic included targeted history, physical exam and a focused ultrasound survey for endometriosis (performed trans-abdominally in all cases, and trans-vaginally in sexually active women). Results: Out of 400 women with suspected endometriosis evaluated in our endometriosis clinic during the study period, 68 were adolescents and young women <22 years old. Their mean age at time of evaluation for endometriosis was 18 ± 2.5 years, and the mean time-period from onset of symptoms to the endometriosis evaluation was 4.0 ± 2.9 years. Their most common symptoms were dysmenorrhea (in 61 cases, 89.7 %), followed by gastrointestinal symptoms (in 32 cases, 47.1 %). In 30 (44.1 %) cases, hormonal treatment was prescribed by the primary care gynecologist prior to their appointment in the endometriosis clinic. On comparison of patients with delay of <4 years (N = 31) versus ≥4 years (N = 37) from symptom onset to the endometriosis evaluation, patients with shorter duration of symptoms were more likely to decline any hormonal treatment for endometriosis while patients with longer duration of symptoms were more likely to accept the recommendation for hormonal treatment (16.2 % versus 0 %, p = 0.02, and 83.8 % versus 100 %, p = 0.03, respectively). Conclusion: Adolescents and young women with suspected endometriosis may experience significant delays in diagnosis and medical care, similar to adult patients.
KW - Adolescents
KW - Deep infiltrating endometriosis
KW - Dysmenorrhea
KW - Endometrioma
KW - Endometriosis
KW - Ultrasound
UR - http://www.scopus.com/inward/record.url?scp=85183990095&partnerID=8YFLogxK
U2 - 10.1016/j.jogoh.2024.102737
DO - 10.1016/j.jogoh.2024.102737
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???
C2 - 38280457
AN - SCOPUS:85183990095
SN - 0368-2315
VL - 53
JO - Journal of Gynecology Obstetrics and Human Reproduction
JF - Journal of Gynecology Obstetrics and Human Reproduction
IS - 3
M1 - 102737
ER -