What question did this study set out to answer?

The aim is to identify risk factors associated with the onset and recurrence of endometriosis in adolescents.

March 26, 2026International Journal of Women s Health0 citationsOpen Access

Risk Factors of Adolescent Endometriosis Onset and Recurrence: A Retrospective Study

YJYang JinWomen's Hospital, School of Medicine, Zhejiang University YPYongchao PanThe Fourth People's Hospital YBY Y BaoWomen's Hospital, School of Medicine, Zhejiang University

Puntos clave

The aim is to identify risk factors associated with the onset and recurrence of endometriosis in adolescents.
Conducted a retrospective analysis of 242 adolescents with endometriosis and 242 age-matched controls.
Collected comprehensive clinical and laboratory variables before and after surgery.
Utilized multivariable logistic regression for onset risk factors and Cox regression for recurrence predictors.
Dysmenorrhea, genital tract malformation, and elevated CA125 identified as key risk factors for onset.
Hypercoagulability and metabolic disturbances were significantly associated with the disease.
Notable recurrence predictors included larger ovarian cyst diameter and shortened activated partial thromboplastin time (APTT).

Resumen

Purpose: This study aimed to identify adolescent-specific risk factors for endometriosis onset and postoperative recurrence to facilitate early identification and risk stratification. Patients and Methods: A retrospective study analyzed adolescents (10– 19 years) undergoing diagnostic laparoscopy for suspected benign gynecological conditions at Zhejiang University Women’s Hospital (2002– 2024). Cases were 242 laparoscopy-confirmed EMs patients; controls were 242 age-matched laparoscopy-negative adolescents. Comprehensive clinical/laboratory variables were collected. Multivariable logistic regression identified onset risk factors. Cox regression analyzed recurrence predictors in followed EMs patients, with recurrence defined by symptomatic, imaging, or surgical confirmation. Results: Dysmenorrhea (aOR 3.61; 95% CI 1.97– 6.63), genital tract malformation (aOR 16.15; 95% CI 3.29– 79.31), and elevated CA125 (aOR 1.02; 95% CI 1.01– 1.04) were independent risk factors of the onset of adolescent endometriosis. Hyperfibrinogenemia (aOR 2.13; 95% CI 1.17– 3.89) and dyslipidemia (hypotriglyceridemia, hypercholesterolemia, low LDL) showed significant associations. Among followed patients (median follow-up 56 months), recurrence rate was 25.3% (23/91). Significant predictors included larger ovarian cyst diameter (aHR 1.24; 95% CI 1.03– 1.49), elevated CA125 (aHR 1.01; 95% CI 1.00– 1.01), and shortened activated partial thromboplastin time (APTT) (aHR 0.77; 95% CI 0.60– 0.99), indicating intrinsic hypercoagulation. Conclusion: This study identifies dysmenorrhea, genital tract malformations, and elevated CA125 as independent risk factors for adolescent EMs onset, with hypercoagulability and metabolic disturbances as key associations. Beyond traditional recurrence markers (cyst size, CA125), shortened APTT emerges as a novel predictor of postoperative recurrence. These findings underscore the need for enhanced screening in high-risk adolescents and intensified postoperative monitoring, particularly for those with coagulation abnormalities. Keywords: endometriosis, adolescent, recurrent endometriosis, dysmenorrhea, risk factors

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