Pathogenesis of Early-Onset Endometriosis

This review discusses competing theories for the pathogenesis of endometriosis, contrasting retrograde menstrual transplantation, induction of endometrial cells, and in situ development, and notes a newer concept that bone-marrow stem/progenitor cells could differentiate into endometrial cells in ectopic sites. The authors argue that early-onset endometriosis may involve a distinct neonatal mechanism, proposing retrograde dissemination of endometrial cells and stroma in neonates during uterine bleeding (visible or occult), potentially carrying endometrial stem cells. They provide historical context distinguishing early views of adenomyosis and endometriosis as separate entities and summarize adult evidence such as familial risk findings and altered gene expression in eutopic endometrium, while emphasizing that the precise mechanisms remain incompletely understood. This paper is centrally about endometriosis—specifically the proposed pathogenesis of early-onset endometriosis and its relationship to neonatal uterine bleeding, with adenomyosis mentioned in the historical framing.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works