The pathogenesis of endometriosis : still searching for answers : review

Endometriosis is defined by the presence of endometrial-like glands and stroma outside of the uterus. It has an incidence of up to 50% in women seeking treatment for pain and infertility, places a large economic burden on countries throughout the world and is functionally debilitating for affected women. Although surgeons and physicians have noted its presence for centuries there is still much debate as to its true etiology. In this presentation we aim to review some of the theories surrounding the pathogenesis of endometriosis under the following themes: background risk, origin, initiation, maintenance and progression of the disease. The progress in understanding the development of endometriosis has paved the way for advances in medical management options and possible non-invasive diagnosis of this condition. Methods: A search was performed on databases: PubMed/MEDLINE, EBSCOHost, BioMed Central, ScienceDirect, Ovid and Internet Archive in September 2014. Keywords used in search were: endometriosis, pathogenesis and pathophysiology. This yielded 132 results, of which 43 articles were reviewed. Additional articles were identified as citations within publications and which were also reviewed.