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Endometriosis occurs when growth of this endometrial tissue develops outside the uterus. This growth usually occurs within the pelvic region on the ovaries and other pelvic structures, such as the bladder and colon, but it may also occur within the abdominal cavity and as far away as the lungs, arms, and legs.
ENDOMETRIOSIS CAUSES and THEORIES
Endometriosis is known as the “Disease of Theories” because no one is absolutely sure why this tissue (endometrium!) begins to grow in the wrong places.
Several different hypotheses have been put forward as to what causes endometriosis. Unfortunately, none of these theories have ever been entirely proven, nor do they fully explain all the mechanisms associated with the development of the disease. Thus, the cause of endometriosis remains unknown.
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Several theories have become more accepted, and reality is that it may be combinations of factors, which make some women to develop endometriosis.
Here are all known theories which are trying to explain the real causes of endometriosis in women:
| Theory 1 |
Retrograde Menstruation
It was suggested that the endometrial tissue is deposited in unusual locations by the backing up of menstrual flow into the Fallopian tubes and the pelvic and abdominal cavity during menstruation (called “retrograde menstruation”). Endometrial cells could escape into the body through the Fallopian tubes and could be deposited onto internal structures such as the ovaries, the bladder, and portions of the large intestine. Once deposited these cells are able to respond to hormones in the same way as normal endometrial tissue in uterus. The growth of misplaced endometrial tissue can cause distortion of abdominal and pelvic structures and causes the development of adhesions within the abdominal and pelvic cavities.
The cause of retrograde menstruation is not clearly understood.
It is unlikely that retrograde menstruation alone is the cause of endometriosis because it is well known that many women have retrograde menstruation in varying degrees, yet not all of them develop endometriosis.
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| Theory 2 |
Coelomic Metaplasia
Another possibility is that areas lining the pelvic organs possess primitive cells that are able to grow into other forms of tissue, such as endometrial cells. This process called “coelomic metaplasia”.)
This theory suggests that a layer of cells surrounding the ovaries and other cells within the pelvic region are able to change into endometrial cells that are much the same as normal endometrial tissue. It is not certain what causes this development, but evidence suggests irritation by retrograde menstrual flow or infections may be the culprit.
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| Theory 3 |
Surgery Transfer
It is also likely that direct transfer of endometrial tissues during surgery may be responsible for the endometriosis implants sometimes seen in surgical scars (for example, episiotomy or Cesarean section scars). Some of the endometrial tissue can be spread or trapped in the abdominal wall and produce endometriosis in the future.
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| Theory 4 |
Bloodstream Theory
Transfer of endometrial cells via the bloodstream (through the blood vessels) or lymphatic system is the most likely explanation for the rare cases of endometriosis that develop in the brain and other organs distant from the pelvis. The presence of many cases of endometriosis which have been reported in the lung, skin, thigh and extremities can be explained by this mode of transport.
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| Theory 5 |
Auto-Immune Theory
Some experts believe that endometriosis is actually part of a larger immunological disorder. This is based on the fact that women with endometriosis have a higher likelihood of developing other problems including lupus, allergies, hypothyroidism or hyperthyroidism. It is thought that there may be a connection between the body’s own immune system and endometriosis. Some studies have shown alternations in the immune response in women with endometriosis, which may affect the body's natural ability to recognize and destroy any misdirected growth of endometrial tissue.
A weakness in the immune system may allow endometrial tissue to take root and grow outside the uterus in women with endometriosis.
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| Theory 6 |
Mutation Theory
It is suggested that sometimes congenital mutation can be a cause of endometriosis. As we develop in the womb some endometrial cells may be misplaced and after puberty these misplaced cells can become active and response to increased hormones.
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| Theory 7 |
Systemic Theory
This theory involves the function of the main endocrine glands which may affect the whole body. Endocrine dysfunctions could be a reason for increased estrogens which could provoke development of endometriosis.
Most scientists, however, agree that endometriosis is exacerbated by estrogen. Subsequently, most of the current treatments for endometriosis attempt to temper estrogen production in a woman's body in order to relieve her of symptoms.
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| Theory 8 |
Genetic Theory
Endometriosis may be an inherited disease as faulty gene patterns are passed on. There is strong evidence to suggest that endometriosis may be genetic. Women who have a family history of the problem are more likely to have it, as are their daughters. \It is suggested that women with certain genetic factors develop endometriosis when they’re exposed to certain environmental triggers. This theory is supported by the fact that endometriosis tends to run in families.
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| Theory 9 |
Environmental
Recent research has highlighted the estrogen-like properties of organochlorines e.g. dioxins in the environment and their possible implication in triggering endometriosis. This is one of the more convincing theories, and a possible explanation as to why endometriosis is occurring more frequently and at a younger age – suggesting that endometriosis is related to environmental toxins, in particular dioxin.
In addition, certain environmental toxins such as PCBs, DDT, and Dioxin and other environmental endocrine disruptors are all associated with endometriosis.
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ENDOMETRIOSIS BIBLE
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Stop Suffering the Living Hell of Endometriosis
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ENDOMETRIOSIS SYMPTOMS
Most women who have endometriosis, in fact, do not have symptoms. Of those who do experience symptoms, the common symptoms are pain (usually pelvic) and infertility.
Endometriosis varies in symptoms and severity depending on the woman and the timing of the menstrual cycle.
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Absence of symptoms
Endometriosis may not produce any specific symptoms, and the women may not be aware of the condition. In fact, most women with endometriosis do not have any specific symptoms of the condition. Sometimes endometriosis can be discovered only because of infertility.
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Pelvic pain
The most common symptom noted by women with endometriosis is pelvic pain that is worse just before menstruation, which then improves at the end of the menstrual period. Women often describe the pain as a constant, aching pain that is deep and often spreads to both sides of the pelvic region, the lower back, abdomen, and buttocks. Pelvic pain usually occurs during or just before menstruation and lessens after menstruation.
Pelvic pain in women with endometriosis depends partly on where the implants of endometriosis are located.
- Deeper implants and implants in areas with many pain-sensing nerves may be more likely to produce pain;
- The implants may also produce substances that circulate in the bloodstream and cause pain;
- Pain can result when endometriosis implants form scars. There is no relationship between severity of pain and how widespread the endometriosis is (the "stage" of endometriosis).
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Menstrual pain and/or Menstrual Cramps
Pain during menstruation (called “dysmenorrheal”) is very common symptom of endometriosis. The age at which endometriosis develops varies considerably. Some adolescent women note painful menstruation when their periods first begin. This condition is later diagnosed as endometriosis, while other women are in their 20s, 30s, or older before endometriosis is diagnosed.
The menstrual pain intensity can change from month to month, and vary greatly among women. Some women experience progressive worsening of menstrual cramps, while others can have resolution of pain without treatment.
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Dyspareunia
Pain during sexual intercourse called “dyspareunia” which could be the main disturbing symptom of endometriosis. Some women could experience painful sexual intercourse (dyspareunia) or cramping during intercourse, and or/pain during bowel movements and/or urination. Even pelvic examination by a doctor can be painful.
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Infertility
Infertility is a common symptom of endometriosis. The exact mechanism by which endometriosis causes infertility is not clear - it may involve physical blocking of the Fallopian tubes due to implants or scarring, or hormonal factors related to the presence of the endometriosis implants. The reasons for a decrease in fertility are not completely understood, but might be due to both anatomic and hormonal factors.
In most cases during laparoscopic examinations (performed for infertility evaluations) endometrial implants can be found on or under the ovaries, behind the uterus, on the tissues that hold the uterus in place and/or on the bowels or bladder.
The presence of endometriosis may involve masses of tissue or scarring (adhesions) within the pelvis that may distort normal anatomical structures, such as Fallopian tubes, which transport the eggs from the ovaries. Alternatively, endometriosis may affect fertility through the production of hormones and other substances that have a negative effect on ovulation, fertilization of the egg, and/or implantation of the embryo.
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Severe abdominal pain
An area of endometriosis on the ovary that has become enlarged is referred to as endometrioma. When the center of this fills with blood, it is known as a chocolate cyst, referring to the appearance of the tissue. Chocolate cysts can become very painful, mimicking the symptoms of other ovarian problems.
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Rare symptoms
Other symptoms related to endometriosis include:
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