Future directions in endometriosis research (original) (raw)

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

International Journal of Reproductive Biomedicine, 2024

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.

Analytical Hypotheses on Possible Etiology and Types of Endometriosis

Journal of Prevention and Infection Control, 2015

Endometriosis is a debilitating disease, of yet unknown etiology, globally affecting about 70 million women in child-bearing age. Previous hypotheses regarding the pathogenesis of endometriosis include retrograde menstruation grounded on peristaltic discharge of menstrual debris into the pelvic peritoneum to form endometrial tissue; the hematological and lymphatic spread theory which proposes seepage of menstrual wreckages into venous and/or lymphatic outflow leading to metastasis; the immunologic concept which assumes weakened or unresponsive immune system and presence of endometrial antibodies and the genetic hypothesis which is based on endometriosis being coded for in the genes of some females. This study takes into consideration imaginable embryonic origin of one type of endometriosis on one hand and on the other hand, viral assaults on the endometrium causing the other type of endometriosis. Therefore, this paper proposes two types of endometriosis, one arising from within the endometrium, which is labelled "endometrial endometriosis" and the other arising from outside the endometrium, hereby referred to as "endometroid endometriosis." These two types of endometriosis may have different presentation and probably require different management.

The epidemiology of endometriosis is poorly known as the pathophysiology and diagnosis are unclear

Best Practice & Research Clinical Obstetrics & Gynaecology

and recognition of subtle lesions is problematic. Reliable surgical data are small series not permitting multivariate analysis. Endometriosis is a hereditary disease. The oxidative stress of heavy menstrual bleeding with retrograde menstruation and an altered pelvic microbiome are probably associated with increasingly severe endometriosis. Whether the prevalence is increasing, or whether endometriosis is associated with fat intake or an increased risk of cardiovascular disease is unclear.

Current concepts in endometriosis

PubMed, 1985

There are no conclusive data available on the incidence or prevalence of endometriosis, yet the notion persists that the frequency of cases has dramatically risen in western societies during the past 25 years. Race, familial predisposition, reproductive history, socioeconomic status, personality type and a historical drop in age at menarche have been posited as risk factors for the complex and as-yet-unclear epidemiology of this disorder. The epidemiology of endometriosis is constrained by the difficulty of the diagnosis. Several analytic concepts from epidemiology, however, could be profitably used to further our knowledge of endometriosis. Included are the case-control study, survival and life-table analyses and correlations of psychologic traits with susceptibility to development of the disease. Though none of these techniques is original or without potential for bias, they may be underutilized in solving the conundrum of endometriosis.

Endometriosis a brief review: evaluation of crucial risk factors and current treatment regimes

International Journal of Advances in Medicine, 2020

Endometriosis is an estrogen-dependent chronic inflammatory disease associated with substantial morbidity, including dyspareunia, dysmenorrhea, pelvic pain, multiple surgery, and infertility. This disease has a high impact on both woman’s physical and mental wellbeing. The etiology of endometriosis is complex and multifactorial. The risk factors associated with the development of endometriosis include family history, menstrual and reproductive cycle, low body mass index (BMI), diet, alcohol uses, smoking, environmental factors, immune system, genetic factors and intrinsic abnormalities in the endometrium. There exist many theories on the initiation and propagation of different types of endometriotic lesions and consequent biological disturbances, of which the most common is the Sampson’s theory according to which the retrograde flow of menstrual blood is linked to the development of endometriosis. Endometriosis affected women have a higher risk than the general female population, fo...