Unlocking the Diagnostic Potential: Noninvasive Biomarkers in Adolescent Endometriosis

Endometriosis in adolescents is an underrecognized yet impactful condition that often presents with nonspecific symptoms such as dysmenorrhea and chronic pelvic pain. Diagnostic delays remain a major barrier, with the current gold standard of laparoscopy being invasive and less acceptable in younger patients. In recent years, noninvasive biomarkers – including circulating glycoproteins, inflammatory cytokines, genetic and epigenetic regulators, proteomic and metabolomic profiles, and urinary, salivary, and menstrual fluid markers – have gained attention for their potential role in early detection. Imaging modalities such as ultrasound and magnetic resonance imaging are essential adjuncts, particularly when integrated with biomarker assays, to improve diagnostic accuracy. Despite encouraging findings, variability across populations, modest sensitivity and specificity, and ethical considerations in adolescent testing remain challenges. Future directions emphasize multi-omics integration, artificial intelligence-based diagnostic algorithms, and longitudinal adolescent cohorts to validate findings and enable translation into clinical practice. Together, these advances hold promise for earlier, safer, and more reliable diagnosis, ultimately improving long-term outcomes for adolescents with endometriosis.