ENDOMETRIOSIS AND ADOLESCENCE

Posted by e-Medical PPT Saturday, November 24, 2012
Endometriosis is a disease or better a syndrome that starts around the prepuberal age, flourishing after menarche, with symptoms progressing in intensity and throughout the years.
The main symptoms are progressive dysmenorhea, premenstrual syndrome, changes in basal body temperature during menstruation and dyspareunia.

MITHS AND FALACIES TO BE BURIED:
"The disease is most frequently seen above the age of 30, though not a few cases are encountered in the late twenties” (Novak & Novak.Text book of Gynecology.Page 557. Fifth Edition 1956.
Adolescents with severe dysmenrrhea are given prescriptions of analgesics or contraceptive pills and are reassured with concepts such as “when you get married pains will stop”or their mothers say “how can a gynecologist see her if she is a virgin”

Numerous papers on Adolescence, pelvic pain and laparoscopies (Reese, Vercellini, grupo Emory, Kontoradvis, Chatman, Creatsas, Laufer & others), report a prevalence of endometriosis ranging from 32 to 73%. Reports of normal internal genitaliae range from 20 to 60%. Therefore....
We believe that invasive procedures should not be used in adolescents with severe dysmenorrhea if their basal body temperature, the so called “Benjamin sign”, has not been investigated.

The premenstrual syndrome was present in 53%.
Cycle alterations only in 35%. (most of them oligomenorrheas)
These 2 items appear to be irrelevant but if one adds them to the others, they turn to be relatively important.
We also obtained important data from their sexual activity.

Dysmenorrhea is to be considered the most important symptom and the most frequent reason for consulting.
Cramps progressing in intensity throughout the years, not responding to conventional therapy, with diarrhea, N & V, changes in character, premenstrual tension, dyspareunia etc. were present in most of our adolescents in different degrees of intensity but at a very high level.
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