Screening for Adolescent Endometriosis
There are various methods to help indicate whether a patient may be suffering from Endometriosis. While these do not explicitly show this disease, these do offer better indications to help prepare a treatment plan. This page will take you through the general steps that will help give more information about how to diagnose a patient.
Medical History
Understanding the medical history of a patient is the most useful screening guide for endometriosis in young children.
Symptom Diary
One of the first steps in assessing pain and symptoms of endometriosis is through an Endometriosis Symptom Diary (ESD). An ESD is a way for the patient to track their pain throughout the duration of their menstrual cycle. The results shown in this diary give clinicians a better way of understanding the experience of the patient. This allows for a more thorough assessment and a more direct line of action for further tests or treatments. These diaries are especially important for adolescent patients who may feel uncomfortable discussing with their doctor or are unable to advocate for themselves.
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The format of the diaries vary. In general, the diaries answer the questions of level and duration of pain, region of pain, when the symptoms occur, the emotional impact, and any other discomfort symptoms that may accompany a patient. There are many great resources that provide blank templates for a patient to fill out. The NHS Endometriosis page lists Endometriosis UK's symptom diary format as an excellent format to use. You can find multiple blank ESD formats by navigating to the "additional resources" tab or clicking the button below.
An example of some pages of symptom diary from an adolescent with endometriosis. The Endometriosis UK ESD template is used.
Genetic Factors
Endometriosis can run in families. It is important to ask about relative experience with this disease. This can better inform treatment plans and screening.
Ultrasound
An ultrasound may be performed on a patient to give a better insight into whether surgical techniques should be done. Ultrasounds are also key in doing differential diagnosis. An absence of findings can indicate that there are not other causes for such severe pain. Endometriomas are rarely found in adolescents, though ultrasounds can catch these instances. Ultrasounds can find large ovarian cysts quite easily. Treatment options for severe pain are usually prescribed before or simultaneously from this step.
Abdominal Ultrasound
An abdominal ultrasound is a common method for visualizing larger cysts. The ultrasound is unable to pick up smaller cysts, so it acts more of a differential diagnosis method. It helps to rule out other common causes of menstrual pain that would show up in the scans.
Transvaginal Ultrasound
A transvaginal ultrasound is another method for differential diagnosis. This option is usually reserved for more extreme cases of endometriosis in adolescents because of its invasive nature.
