Time to Diagnose for Adolescent Endometriosis in West Java, Indonesia Population: A Single Centre 2 Years Retrospective Descriptive Study

Abstract

Purpose Endometriosis affects approximately 10% of reproductive-age women and up to 20% of those with infertility. Despite rising awareness in adults, adolescent endometriosis remains underrecognized, especially in Southeast Asia. This study aimed to evaluate early symptoms and diagnostic timelines of adolescent endometriosis in West Java over the past three years. Patients and Methods This retrospective descriptive study was conducted at Hasan Sadikin General Hospital, a tertiary referral center in West Java, Indonesia. Adolescents aged ≤ 22 years with surgically and histopathologically confirmed endometriosis between October 2022 and October 2024 were included. Primary outcomes were age at symptom onset, age at diagnosis, and diagnostic delay. Secondary outcomes included presenting symptoms and disease stage based on the revised American Society for Reproductive Medicine (ASRM) classification. Patients were contacted by telephone to complete a structured questionnaire after consent; ethical approval was obtained. Results The mean (SD) age at diagnosis was 20.31 (±2.55) years, while the mean age at symptom onset was 17.8 (±2.65) years. The mean diagnostic delay was 32.28 (±22.74) months (range 1–72 months). The most common symptom was dysmenorrhea (52%), followed by severe dysmenorrhea (31%), heavy menstrual bleeding (14%), dyspareunia (10%), and dysuria (1%). Most patients presented with advanced disease: among 29 cases, 15 were stage III and 13 were stage IV. Conclusion Adolescent endometriosis in West Java is characterized by delayed diagnosis and advanced-stage presentation, likely influenced by low awareness and sociocultural factors. Early recognition of persistent menstrual pain may reduce diagnostic delay and prevent disease progression.