ACOG has released recommendations on the diagnosis and management of dysmenorrhea and endometriosis in adolescents.
The goals of therapy include symptom relief, suppression of disease progression, and protection of future fertility. Therapy must be individualized, and obstetrician–gynecologists should consider patient choice, the need for contraception, contraindications to hormone use, and potential adverse effects and counsel the adolescent and her family on treatment options.
Note: Pelvic pain that persists for 3 to 6 months warrants further evaluation for other causes of chronic pelvic pain such as GI, GU, MSK or psychological
Diagnosis of endometriosis
Management of endometriosis
ACOG Committee Opinion 760: Dysmenorrhea and Endometriosis in the Adolescent
Endometriosis is a chronic condition that results in infertility and chronic pain. Clinical manifestations vary and are not good predictors of the severity of the disease. Dysmenorrhea, chronic pain, dyspareunia, uterosacral ligament nodularity, and adnexal masses are among the common presentations. Treatment is aimed at optimizing pregnancy rates and minimizing symptoms; definitive treatment remains removal of the ovaries, fallopian tubes and uterus.
ACOG Practice Bulletin No. 114: Management of Endometriosis
ASRM: Treatment of Pelvic Pain Associated with Endometriosis: A Committee Opinion
Pathophysiology, diagnosis, and management of endometriosis
Optimal Management of Endometriosis and Pain
Endometriosis: Where Are We and Where Are We Going?
Gastrointestinal and Urinary Tract Endometriosis: A Review on the Commonest Locations of Extrapelvic Endometriosis
FDA: HIGHLIGHTS OF PRESCRIBING INFORMATION for ORILISSA (Elagolix)
FDA: HIGHLIGHTS OF PRESCRIBING INFORMATION for MYFEMBREE (Relugolix)
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