Current Knowledge on Endometriosis Etiology: A Systematic Review

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Current Knowledge on Endometriosis Etiology: A Systematic Review

A relatively recent systematic review article of everything relevant that has been published over the last several decades, provides a comprehensive overview of the current knowledge on the etiology (causes) of endometriosis. The authors discuss the various hypotheses that have been proposed for the development of endometriosis, including retrograde menstruation, genetic predisposition, immunological dysfunction, hormonal imbalances, and environmental factors. They also examine the evidence supporting each hypothesis and highlight areas where further research is needed. Overall, the review emphasizes the complex and multifactorial nature of endometriosis and the need for a multidisciplinary approach to its diagnosis and treatment.

What is Endometriosis Overall?

Endometriosis is a chronic and debilitating inflammatory gynecological disorder characterized by the growth of endometrial-like tissue outside of the uterus, often leading to chronic pelvic pain and infertility. Despite extensive research efforts, the exact causes of endometriosis remain unknown. There are however several leading theories and they may overlap in any given individual.

This systematic review aims to provide an up-to-date summary of the current knowledge on the etiology of endometriosis. The authors systematically searched and analyzed the literature on various hypotheses that have been proposed for the development of endometriosis, including retrograde menstruation, genetic predisposition, immunological dysfunction, hormonal imbalances, and environmental factors.

What Are The Best Theories Today?

Retrograde menstruation is the most widely accepted hypothesis and suggests that menstrual blood and endometrial tissue backflow through the fallopian tubes into the pelvic cavity, where it implants and grows outside of the uterus. However, this hypothesis does not explain why some women with retrograde menstruation do not develop endometriosis, nor does it account for the presence of endometriosis outside of the pelvic cavity, especially if it is transmitted through the lymphatic or blood systems.

Genetic predisposition is another possible factor in endometriosis development, with several genes implicated in its pathogenesis. Immunological dysfunction may also play a role, as endometriosis has been associated with altered immune function, chronic inflammation, and oxidative stress. Hormonal imbalances, such as increased estrogen levels and decreased progesterone levels, may also contribute to the development of endometriosis.

Lastly, the review discusses environmental factors, such as exposure to endocrine-disrupting chemicals which act like estogens, which have been shown to disrupt the hormonal balance and potentially increase the risk of endometriosis. However, the evidence on environmental factors remains limited and requires further investigation. These are otherwise known as the “toxins” one should be aware of and avoid.

Summary Findings

Overall, the review concludes that endometriosis is a complex and multifactorial condition, with various factors potentially contributing to its development. A better understanding of its etiology will lead to earlier diagnosis and improved treatments. Therefore, multidisciplinary research efforts are needed to uncover the underlying causes of endometriosis and develop more effective treatments. It will not likely be a single answer but the combined therapies will be more effective to keep endo away and potentially prevent it as well.

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“I help and guide women to beat endometriosis and gynecologic cancers that are associated with endo, like ovarian cancer, using a unique combination of minimally invasive robotic surgery, precision medicine therapies and complementary holistic natural support towards thriving in survivorship." Dr. Vasilev is the only physician triple board certified in Ob-Gyn, Gynecologic Oncology and Integrative & Holistic Medicine in the United States. He is an accomplished advanced robotic master surgeon, and is internationally vetted by iCareBetter (https://icarebetter.com/doctor/dr-steven-vasilev/). He serves as Professor at the world-renowned Saint John's Cancer Institute in Santa Monica, California and is Clinical Professor at Loma Linda University School of Medicine. He is former faculty and professor at UC Irvine, UCLA, USC and City of Hope and was the founding Medical Director of Integrative Medicine at Providence Saint John's Health Center. He is an active member of multiple medical societies and has been nationally listed in "Best Doctors" for over 20 years.