Long-Term Burden of Adolescent-Onset Endometriosis: A Case Report Highlighting Recurrent Disease and Fertility-Preserving Dilemmas

Adolescent-onset endometriosis is increasingly recognized as a distinct clinical challenge. It often requires years to achieve a diagnosis, leading to prolonged physical and psychological distress and significantly impairing quality of life. We report the case of a 37-year-old woman with endometriosis first diagnosed in adolescence. Long‑term management was complicated by an inability to tolerate continuous hormonal therapy because of adverse effects, resulting in multiple recurrences. After infertility treatment, she achieved pregnancy but required an emergency cesarean section for placenta previa. Due to the persistent severe treatment-refractory pain, she underwent a laparoscopic total hysterectomy with bilateral adnexectomy. Postoperatively, pain resolved completely, and she has remained symptom-free on hormone replacement therapy. This case illustrates the substantial lifelong burden that adolescent‑onset endometriosis can impose, including recurrent disease, complex fertility decisions, and significant impacts on quality of life. Early recognition and sustained multidisciplinary follow‑up, considering fertility goals, are essential to improve long‑term outcomes.