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Adolescent and Early-Onset Adenomyosis: Phenotypes, Diagnostic Challenges, and Fertility-Conscious Care

Year: 2026

Type: article

Abstract: Adolescent and early-onset adenomyosis is increasingly recognized in symptomatic young patients, but its clinical significance remains uncertain.This narrative review synthesizes English-language literature on adolescent and early-onset adenomyosis, distinguishing direct adolescent and young-adult evidence from supportive evidence derived from adult populations.Current data suggest that adenomyosis-like imaging features may be identified in adolescents with severe dysmenorrhea, heavy menstrual bleeding, chronic pelvic pain, or coexisting endometriosis.Early disease often appears as subtle diffuse inner-myometrial change, focal lesions, or cystic/juvenile forms rather than the classic diffuse adult phenotype.Ultrasound is the first-line imaging modality, whereas MRI is reserved for equivocal findings, atypical cystic lesions, suspected congenital anomalies, or endometriosis overlap.Management requires a stepwise, symptomoriented approach that considers future reproductive options and avoids unnecessary uterine intervention.Overall, adolescent adenomyosis should be considered in patients with severe or treatment-resistant menstrual symptoms, while uncertain imaging findings should not be overinterpreted.

Source: International Journal of Medical Sciences

DOI: 10.7150/ijms.140803

Authors: Shuhong Yang, Yuling Chen, Xiangyi Ma

Institutions: Tongji Hospital, Huazhong University of Science and Technology

Language: English

Topic: Endometriosis Research and Treatment

Subfield: Reproductive Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,337