A new look at the theoretical causes of endometriosis: Narrative review

Abdelmonem Awad Hegazy, Awad Hegazy A
International journal of reproductive biomedicine · 2024 · vol. 22(5) , pp. 343–356 · doi:10.18502/ijrm.v22i5.16433 · PMID:39091427 · PMC11290193 · W4400427538
review OA: gold CC0 ⤵ 4 in-corpus citations
📄 Open PDF Full text JSON View on OpenAlex View on PubMed View at publisher
⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This review examines proposed theories for endometriosis pathogenesis, finding retrograde menstruation the most accepted but its precise causes, and potential links to sexual activity during menstruation, remain uncertain.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text ⓘ

This narrative review examines the classification of endometriosis and synthesizes proposed theoretical causes of its pathogenesis using database-identified literature. The authors report that retrograde menstruation is considered the closest and most accepted theory, but they highlight ongoing uncertainty about why it occurs, including in women without menstrual outflow obstruction, and they note hypotheses linking sexual activity during menstruation to development of endometriosis that require more evidence. A key limitation is that the work is not an original study and depends on the breadth and selection of existing theories rather than new causal data. This paper is centrally about endometriosis — it reviews and evaluates competing theoretical causes, emphasizing retrograde menstruation and possible roles of sexual activity during menstruation.

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

Abstract

Endometriosis is a major health concern in women who have it. Unfortunately, there is no definitive cure except panhysterectomy with its sequelae including induction of premature menopause due to loss of ovaries. Therefore, revealing the causes of this puzzling disease is necessary to avoid contracting it, and to spare women the health disorders resulting from it and the difficulties of treating it. We aimed to study endometriosis with a focus on its theoretical causes. Its classification reports and theories of pathogenesis were identified and studied from available database searches. The causes of endometriosis remain mysterious. Many theories have been proposed to explain the etiology, but retrograde menstruation (RM) remains the closest in this regard. Although this theory is the most accepted in the pathogenesis of endometriosis, its causes are still a matter of debate, especially in women who do not suffer from obstructions to menstrual outflows, such as cases of congenital cervical stenosis and imperforate hymen. It is suggested in some studies that there may be a relationship between women who engage in sexual activity during menstruation and the development of endometriosis. It is concluded that endometriosis is a painful and debilitating disease. Identifying its causes is essential to control the disease and avoid any burdens on health. RM is the main theory for its pathogenesis but its causes are still uncertain. Sexual activity during menstruation may be a possible cause of RM but needs more evidence. Future studies are recommended to reveal all aspects of the pathogenesis of endometriosis.
Full text 29,589 characters · extracted from pmc-nxml · 2 sections · click to expand

Section

The author had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Coi Statement

The author declares that there is no conflict of interest.

Text is read by the "Ask this paper" AI Q&A widget below. Extraction quality varies by source — PMC NXML preserves structure cleanly, OA-HTML may include some navigation residue, and OA-PDF can have broken hyphenation. The publisher copy (via DOI) is the canonical version.

My notes (saved in your browser only)

⚙ Ask this paper AI returns verbatim quotes from the full text · source: pmc-nxml ⓘ

Answers must be backed by verbatim quotes from this paper's full text. Hallucinated quotes are dropped automatically; if no verbatim passage answers the question, we say so. How this works

Outcome instruments

rASRM

Condition tags

endometriosis

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (92)

Cited by (5)

Source provenance

europepmc
last seen: 2026-07-27T06:15:28.040536+00:00
openalex
last seen: 2026-06-10T17:14:06.276822+00:00
pmc
last seen: 2026-05-13T20:22:03.195721+00:00
pubmed
last seen: 2026-07-27T06:12:51.684450+00:00
License: CC0 · commercial use OK