Treating dysmenorrhea in adolescents: when to think to endometriosis

When confronted to a young girl complaining of dysmenorrhea, diagnosis is mainly based on the interrogation and clinical examination. Abdominal or transvaginal ultrasound in non-virgin adolescent is useful. Pelvic examination, pregnancy test, sexual transmitted diseases screening and Magnetic Resonance Imaging may help exclude other causes of pain. As a last resort, when medical treatment is insufficient and additional examinations negative, an exploratory laparoscopy could be proposed.
More recently, a new non-invasive diagnostic tool based on miRNA assessment in the saliva is being evaluated to avoid surgery in such young patients.