Stem cell theory for the pathogenesis of endometriosis

This paper reviews existing hypothetical causes of endometriosis—including retrograde menstruation, lymphatic/vascular spread, iatrogenic implantation, coelomic metaplasia, embryonic rests, and mesenchymal differentiation—and argues that no single theory explains all lesion types, implying combined and/or type-specific mechanisms. It synthesizes recent evidence for endometrial stem/progenitor cells and their potential role in regenerating and differentiating eutopic endometrium. The central proposed addition is that endometriotic lesions may originate from ectopic endometrial stem/progenitor cells. The paper is a narrative review based on the current evidence rather than presenting new experimental data. This paper is centrally about endometriosis — it proposes an additional stem/progenitor-cell–based mechanism for lesion origin within endometriosis pathogenesis.

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