Etiology and histogenesis of endometriosis.
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Endometriosis develops via transplantation of shed endometrial fragments regurgitated through the fallopian tubes, with increased menstrual days and outflow obstruction correlating to higher incidence.
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Abstract
Based on the available scientific evidence, the mechanism of developing endometriosis appears to be transplantation of viable endometrial cell fragments shed during menses and regurgitated through the fallopian tubes under the influence of prostaglandin-mediated uterine contractions. As all women apparently retrograde menstruate to some extent, it is not surprising that circumstances which increase the total number of menstrual days experienced have been clinically associated with endometriosis. Similarly, factors which lead to relative uterine outflow obstruction have been associated with a higher incidence of endometriosis. There is virtually no other scientific evidence supporting alternate mechanisms of development of endometriosis. There are many unanswered questions regarding endometriosis including: 1) Are all women equally susceptible to development of the disease? 2) As the clinical presentation and course is extremely variable, what factors influence these events? 3) Does medical suppression of ovulation with oral contraceptives or continuous progestins provide a protective effect? 4) Are there systemic immunologic changes associated with endometriosis? Hopefully, this manuscript will help stimulate the next generation of clinical investigators to address these questions, as they are of paramount importance with this apparently increasingly devastating and frequent clinical disease.
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Cited by (19)
- A RARE CASE OF URINARY BLADDER ENDOMETRIOSIS FOLLOWING CESAREAN SECTION 2015
- Lymphokine activated killer cells from peripheral blood mononuclear cells of endometriosis of patients improve cytotoxicity to endometriosis cell culture 2011
- Pathogenesis of Endometriosis 2010
- Negotiating science and experience in medical knowledge: Gynaecologists on endometriosis 2009
- Gene Expression Profiling of the Rat Endometriosis Model 2007
- A young woman with endometriosis of kidney 2006
- Soluble factors from human endometrium promote angiogenesis and regulate the endothelial cell transcriptome 2004
- Dioxin stimulates RANTES expression in an in-vitro model of endometriosis 2002
- Dioxins and endometriosis: a plausible hypothesis. 2002
- Macrophage secretory products and sperm zona pellucida binding 2001
- Expression of AhR and ARNT mRNA in Cultured Human Endometrial Explants Exposed to TCDD 2001
- Could tight garments cause endometriosis? 1999
- Effect of prenatal exposure to TCDD on the promotion of endometriotic lesion growth by TCDD in adult female rats and mice 1999
- Increased expression of complement component 3 in human ectopic endometrium compared with the matched eutopic endometrium 1997
- Morphologic characteristics of endometriosis in the mouse model: application to toxicology 1997
- Renal and Diaphragmatic Endometriosis De Novo Associated With Hormone Replacement Therapy 1995
- Towards an ecosystemic understanding of Endometriosis 1994
- Menstrual Cycle Characteristics and the Risk of Endometriosis 1993
- Characterization of human purified epithelial and stromal cells from endometrium and endometriosis in tissue culture 1992
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