We trace the line from “bad cramps” to a careful, compassionate evaluation for endometriosis, showing how physiology, history, and practical treatment choices restore a teen’s daily life. Evidence, empathy, and clear steps help shorten the long road to relief and reduce missed school and stress.

• defining primary and secondary dysmenorrhea and why prostaglandins matter
• prevalence figures and diagnostic uncertainty in adolescents
• first line management with timed NSAIDs and continuous hormonal therapy
• what to ask in the menstrual and symptom history
• when to suspect endometriosis after failed therapy
• broad differential including GI, GU, musculoskeletal and psychological causes
• limits of labs and imaging and the value of diaries
• multimodal care: PT, TENS, CBT, neuropathic agents
• GnRH options with add back and prudent use of surgery
• staging limits and mismatch with pain severity
• mental health, trauma awareness and inclusive care for trans patients

What is PAG?
Pediatric and Adolescent Gynecology is a subspecialty of OBGYN (2 year fellowship) focusing on reproductive healthcare for children and young adults. It fills the overlap between general gynecologists and pediatricians. It is a multi-disciplinary field involving work with pediatric endocrinology, dermatology, hematology, surgery, ect. Go to NASPAG.org for more PAG educational resources.

Want to test your knowledge?
PAG WebEd cases are a great way to review our podcast content.