How do women get endometriosis?

Area of Science:

• Reproductive Medicine
• Evolutionary Biology
• Epidemiology

Background:

• The exact causes of endometriosis, a condition affecting many women, remain unclear despite extensive research.
• Sampson's retrograde menstruation theory is widely accepted but fails to explain the discrepancy between its high prevalence and the moderate incidence of endometriosis.
• Existing theories do not fully account for the observed prevalence rates of endometriosis.

Purpose of the Study:

• To propose a novel hypothesis for the pathogenesis of endometriosis.
• To explain the gap between retrograde menstruation and endometriosis prevalence.
• To offer a new perspective for future research and treatment strategies.

Main Methods:

• This study presents a theoretical perspective, synthesizing existing knowledge on endometriosis and evolutionary biology.
• It analyzes the potential impact of societal and cultural changes on reproductive health.
• The authors propose a framework for understanding endometriosis risk factors in the context of human evolution.

Main Results:

• Endometriosis may arise from a maladaptation of evolutionary traits to drastically altered modern societies and cultures.
• Numerous potential risk factors for endometriosis, absent in ancestral hunter-gatherer societies, have emerged due to these societal shifts.
• These evolutionary mismatches could explain the disparity between the common occurrence of retrograde menstruation and the actual prevalence of endometriosis.

Conclusions:

• Endometriosis pathogenesis is likely influenced by the mismatch between our evolutionary legacy and contemporary lifestyles.
• This evolutionary perspective offers a new framework for investigating endometriosis.
• It may pave the way for novel disease prevention and treatment approaches.