The clinical profile of young and adolescent women with laparoscopically diagnosed endometriosis in a Singapore tertiary hospital

Abstract Objective Endometriosis has been increasingly recognized as the cause of severe dysmenorrhea among younger women including adolescents, often with significant delay from time of presentation to diagnosis. Data on the South East Asian women is scarce. This study aims to describe the disease pattern in a group of young Asian women with histological diagnosis of endometriosis in our center. Materials and Methods A total of 709 laparoscopic operations were performed for endometriosis in our center between 2000 and 2007. Women aged 25 years old and below were included in this study. Details regarding clinical presentation and severity of disease were retrospectively reviewed and described. Results A total of 45 women were included in this study, aged between 14 years and 25 years. Thirty seven patients (82.3%) were aged between 21 years and 25 years. Racial distribution was as follows: 57.8% Chinese, 26.7% Malay, and 15.6% Indian. Dysmenorrhea was the commonest symptom (84.4%); 44.4% of which were described as mild. Eleven patients (24.4%) presented with severe symptoms resulting in absence from school or work. Severity of endometriosis during laparoscopy was staged using the rAFS staging system, and was 11.1%, 17.8%, 28.9%, and 42.2% for disease Stage I, Stage II, Stage III, and Stage IV, respectively. Conclusion Endometriosis can cause severe disease even in adolescents and young females. Increased awareness among patients and healthcare providers would raise a higher index of suspicion for endometriosis in these women, with consequent early treatment which may result in better functional and fertility outcomes.