L26/P-339 Implementation of a Hospital-School Collaborative Model for Early Detection and Multidisciplinary Management of Adolescent Dysmenorrhea and Early-Onset Endometriosis: A Prospective Cohort Study

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Abstract Study question Can a standardised hospital-school collaborative model improve early detection and multidisciplinary management of adolescent dysmenorrhea and suspected early-onset endometriosis? Summary answer Yes, this model significantly increased early detection rates, improved pain control and quality of life, and promoted positive health behaviours among affected adolescents. What is known already Endometriosis is a leading cause of chronic pelvic pain and infertility in reproductive-aged women, with pathogenesis often starting in adolescence. Despite evidence that early interventions may mitigate disease progression and preserve fertility, diagnostic delays persist due to symptom normalisation and lack of systematic screening in most healthcare settings. Study design, size, duration In this prospective cohort study, a multidisciplinary hospital-school intervention was implemented across 11 secondary/elementary schools. A total of 3,300 adolescents were enrolled and followed for 6 months, with detection rates and clinical outcomes assessed using standardised measures. Participants/materials, setting, methods A multidisciplinary team delivered ≥3 annual health education sessions per school, alongside standardised risk screening (menstrual history, pain characteristics, lifestyle, and psychological status). High-risk adolescents (moderate-severe dysmenorrhea, progressive symptoms, or imaging abnormalities) received stratified interventions (health education, lifestyle modification, pharmacotherapy, psychological support, and follow-up). Primary outcomes included VAS pain scores, quality-of-life impairment, endometriosis diagnosis rates, and health behaviour change. Statistical analyses were performed using paired t-tests, χ² tests, and multivariate regression (P < 0.05). Main results and the role of chance Among 3,300 participants (aged 10-16 years), 3,015 completed screening (91.4% response rate). Dysmenorrhea was reported in 2,451 cases (81.3%), with 182 (6.0%) classified as high-risk. Of 124 clinically evaluated, 52 were diagnosed with early-onset endometriosis (1.7% of total). At 6-month follow-up, significant improvements were observed: mean VAS scores decreased from 7.1±1.2 to 3.6±1.3 (P < 0.01); academic impairment declined from 63.8% to 26.9%(P < 0.01); regular exercise adherence increased from 44.5% to 81.3%, and medication compliance improved from 28.7% to 74.2%. Multivariate analysis identified protective factors, including regular exercise (OR = 0.53, P < 0.05), structured health education (OR = 0.48, P < 0.05), and early pharmacotherapy (OR = 0.50, P < 0.05). The program also significantly enhanced disease awareness among students and parents. Limitations, reasons for caution Single-center recruitment and urban sampling may limit generalizability, while the 6-month follow-up period precludes evaluation of long-term fertility outcomes. Wider implications of the findings This hospital-school collaborative model effectively enhances early detection and clinical outcomes through standardised risk stratification and tiered interventions. The scalable framework reduces diagnostic delay and empowers adolescents via targeted education, offering transformative strategies for global adolescent health programs. Trial registration number No

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