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Pathogenesis of endometriosis
Emre Seli1, Murat Berkkanoglu, Aydin Arici
1Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520-8063, USA.
Obstetrics and Gynecology Clinics of North America
|April 18, 2003
Summary
Endometriosis, a common gynecologic disorder, occurs when uterine lining tissue grows outside the uterus. While retrograde menstruation is a leading theory, other factors like immune changes and genetics influence disease development.
Area of Science:
- Gynecology
- Reproductive Medicine
- Cell Biology
Background:
- Endometriosis is a prevalent gynecologic condition where endometrial tissue implants outside the uterus.
- The exact causes remain unclear, but several theories exist.
- The retrograde menstruation theory is widely accepted but doesn't explain all cases.
Purpose of the Study:
- To review the current understanding of endometriosis development.
- To highlight the significance of retrograde menstruation as a potential cause.
- To discuss additional factors contributing to endometriosis susceptibility.
Main Methods:
- Literature review of existing theories and research on endometriosis.
- Analysis of the prevalence of retrograde menstruation in women.
- Examination of cellular and molecular mechanisms involved in endometrial cell survival and implantation.
Main Results:
- Retrograde menstruation occurs in a high percentage of women (76-90%).
- Endometriosis prevalence is significantly lower than the rate of retrograde menstruation, indicating other contributing factors.
- Abnormal expression of MMPs and TIMPs, immune dysregulation, local aromatase activity, and genetic/environmental factors play roles in disease development.
Conclusions:
- Retrograde menstruation is a common event but not sufficient for endometriosis development.
- Susceptibility to endometriosis involves a complex interplay of factors beyond tissue reflux.
- Further research into immune, genetic, and environmental influences is crucial for understanding and treating endometriosis.