Current theories on endometriosis pathogenesis

2020 · doi:10.5348/m12-2015-1-ed-1 · W1251552486
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⚙ AI-generated summary by claude@2026-06, 2026-06-06 ⓘ

This review summarizes current theories regarding the pathogenesis of endometriosis, a common gynecological disorder characterized by ectopic endometrial tissue with an unknown definitive cause.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-06 ⓘ

This short review summarizes major theories of endometriosis pathogenesis, focusing on possible causes such as retrograde menstruation, in situ development mechanisms (including Müllerian/Wolffian rest, coelomic metaplasia, and endometrial stimulation), altered steroid biosynthesis and receptor signaling, enhanced vascularization, and roles for endometrial or bone-marrow-derived stem/progenitor cells and fallopian tube–derived cells. It highlights that endometriosis is linked to pain and infertility, and also to ovarian cancer risk, including hypotheses that atypical endometriosis may be premalignant, while noting that the underlying mechanisms of malignant transformation remain unclear. The review explicitly cautions that no single theory explains all cases and calls for more research and improved animal models. This paper is centrally about endometriosis — it surveys current theories of endometriosis pathogenesis, including mechanisms that discuss estrogen signaling in relation to endometriotic and adenomyotic tissue.

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Abstract

Endometriosis is a common chronic gynecological disorder affecting more than 10% of women of reproductive age. It is characterized by the presence of endometrial glands and stroma outside the uterine cavity. Despite the fact that our knowledge of this disease is older than 150 years, our knowledge of the pathogenesis of endometriosis is far from complete. In this short review, we summarize the current theories on possible causes of endometriosis. Our knowledge of endometriosis extends back to 1860, when von Rokitansky first described this disease [1]. This disease is characterized by the presence of ectopic endometrium resulting in pain, infertility and/ or lesion progression. Between 5 and 10% of women of reproductive age are affected. Despite the long research, the definite cause(s) of endometriosis is still unsolved and this disorder remains among the most enigmatic women diseases. Endometriosis is not only connected with infertility, but also with several types of cancer, most of all ovarian. Based on histopathological studies, it was suggested that atypical endometriosis is in fact a premalignant condition [2]. This hypothesis is nothing new, as the relation between endometrial tissue and ovarian cancer was described almost 100 years ago [3]. Studies evaluating ovarian cancer patients showed 10% occurrence of transformed endometriomas [4], this incidence in patients with clear cell ovarian cancer is

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endometriosisinfertility

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