The Origins of Endometriosis

One of the axioms of medicine is that to successfully treat a disease, one needs to understand its etiology, epidemiology and demographics. Endometriosis is no exception. This chapter provides an overview of the condition, from a review of its apparently growing prevalence as more and more diagnostic laparoscopies are performed to more up to date consideration of the various concepts in its aetiology. From the early ideas of retrograde menstruation to embryological studies demonstrating evidence of endometriosis in fetal life have given credance to the theory of Mulleriosis. This has led to an understanding of the epigenetics of endometriosis which in turn is essential in the life-long management of endometriosis. An understanding of the features of endometriotic implants when they are still cell rests may lead to innovative treatments which may reduce the need for extensive and potentially debilitating surgery.