19 - Endometriosis in the Adolescent

We trace the line from “bad cramps” to a careful, compassionate evaluation for endometriosis, showing how physiology, history, and practical treatment choices restore a teen’s daily life. Evidence, empathy, and clear steps help shorten the long road to relief and reduce missed school and stress.• defining primary and secondary dysmenorrhea and why prostaglandins matter• prevalence figures and diagnostic uncertainty in adolescents• first line management with timed NSAIDs and continuous hormonal therapy• what to ask in the menstrual and symptom history• when to suspect endometriosis after failed therapy• broad differential including GI, GU, musculoskeletal and psychological causes• limits of labs and imaging and the value of diaries• multimodal care: PT, TENS, CBT, neuropathic agents• GnRH options with add back and prudent use of surgery• staging limits and mismatch with pain severity• mental health, trauma awareness and inclusive care for trans patientsWhat is PAG?Pediatric and Adolescent Gynecology is a subspecialty of OBGYN (2 year fellowship) focusing on reproductive healthcare for children and young adults. It fills the overlap between general gynecologists and pediatricians. It is a multi-disciplinary field involving work with pediatric endocrinology, dermatology, hematology, surgery, ect. Go to NASPAG.org for more PAG educational resources.Want to test your knowledge?PAG WebEd cases are a great way to review our podcast content.