Endometriosis from thelarche to midteens: pathogenesis and prognosis, prevention and pedagogy

John Huffman, a founder of the subspecialty of pediatric and adolescent gynecology in North America, first related the diagnosis of endometriosis to thelarche. Subsequently, endometriosis was diagnosed in early puberty between thelarche and menarche. Based on solid evidence, we suggest that the theo...

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Bibliographic Details
Published in:Journal of pediatric & adolescent gynecology 2003-12, Vol.16 (6), p.337-347
Main Authors: Batt, Ronald E, Mitwally, Mohamed F M
Format: Article
Language:English
Subjects:
Adolescent
Computational Biology
Early Diagnosis
Endometriosis - etiology
Endometriosis - prevention & control
Female
Humans
Laparoscopy
Palpation
Patient Education as Topic
Prognosis
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Summary:John Huffman, a founder of the subspecialty of pediatric and adolescent gynecology in North America, first related the diagnosis of endometriosis to thelarche. Subsequently, endometriosis was diagnosed in early puberty between thelarche and menarche. Based on solid evidence, we suggest that the theory of embryonic mullerian rests be added to currently accepted theories of pathogenesis of endometriosis. This article argues for recognition of embryonic mullerian rests as the pathogenesis of some cases of endometriosis not explained by accepted theories. Along with Huffman, we propose that thelarche be recognized as a developmental benchmark, after which endometriosis is included in the differential diagnosis of chronic pelvic pain. Thus, in an effort to refocus research and patient care to early adolescence, this review is limited to endometriosis occurring in young women from thelarche to their sixteenth birthday. Relating endometriosis to thelarche has fundamental implications for pathogenesis, early diagnosis, prognosis, treatment, education, and long-term care of adolescents.
ISSN:1083-3188
DOI:10.1016/j.jpag.2003.09.008