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Review
. 2023 Feb 21;24(5):4254.
doi: 10.3390/ijms24054254.

The Main Theories on the Pathogenesis of Endometriosis

Jelizaveta Lamceva  1 , Romans Uljanovs  2 , Ilze Strumfa  2
Affiliations
Review

The Main Theories on the Pathogenesis of Endometriosis

Jelizaveta Lamceva et al. Int J Mol Sci. .

Abstract

Endometriosis is a complex disease, which is defined by abnormal growth of endometrial tissue outside the uterus. It affects about 10% of women of reproductive age all over the world. Endometriosis causes symptoms that notably worsen patient's well-being-such as severe pelvic pain, dysfunction of the organs of pelvic cavity, infertility and secondary mental issues. The diagnosis of endometriosis is quite often delayed because of nonspecific manifestations. Since the disease was defined, several different pathogenetic pathways have been considered, including retrograde menstruation, benign metastasis, immune dysregulation, coelomic metaplasia, hormonal disbalance, involvement of stem cells and alterations in epigenetic regulation, but the true pathogenesis of endometriosis remains poorly understood. The knowledge of the exact mechanism of the origin and progression of this disease is significant for the appropriate treatment. Therefore, this review reports the main pathogenetic theories of endometriosis based on current studies.

Keywords: carcinogenesis; endometriosis; epigenetics; immune regulation; metaplasia; oestrogen; pathogenesis; progesterone; stem cells.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Immunocompetent cells in endometriosis. Figure replicated from [21] under Creative Commons license, provided at https://creativecommons.org/licenses/by-nc/4.0/ (accessed on 17 January 2023). Changes made: Figure legend, figure modification.
Figure 2
Figure 2
The effects of progesterone and oestrogen dysregulation on endometrium. Figure replicated from [38] under Creative Commons license, provided at https://creativecommons.org/licenses/by-nc/4.0/ (accessed on 17 January 2023). Changes made: Figure legend.
See this image and copyright information in PMC

References

    1. World Health Organization. [(accessed on 27 September 2022)]. Available online: https://www.who.int/news-room/fact-sheets/detail/endometriosis.
    1. Saunders P.T.K., Horne A.W. Endometriosis: Etiology, pathobiology, and therapeutic prospects. Cell. 2021;184:2807–2824. doi: 10.1016/j.cell.2021.04.041. - DOI - PubMed
    1. Smolarz B., Szyłło K., Romanowicz H. Endometriosis: Epidemiology, classification, pathogenesis, treatment and genetics (Review of literature) Int. J. Mol. Sci. 2021;22:10554. doi: 10.3390/ijms221910554. - DOI - PMC - PubMed
    1. Ahn S.H., Singh V., Tayade C. Biomarkers in endometriosis: Challenges and opportunities. Fertil. Steril. 2017;107:523–532. doi: 10.1016/j.fertnstert.2017.01.009. - DOI - PubMed
    1. Horne A.W., Saunders P.T.K. SnapShot: Endometriosis. Cell. 2019;179:1677. doi: 10.1016/j.cell.2019.11.033. - DOI - PubMed