Theories on the Pathogenesis of Endometriosis

Table 1

Role of the different theories in the pathogenesis of endometriosis.

Theory	Mechanism
Retrograde menstruation	Flow of endometrial content into pelvis, allowing implantation of endometrial lesions
Metaplasia	Transformation of peritoneal tissue/cells into endometrial tissue through hormonal and/or immunological factors
Hormones	Oestrogen-driven proliferation of endometrial lesions. Resistance to progesterone-mediated control of endometrial proliferation
Oxidative stress and inflammation	Recruitment of immune cells and their production of cytokines that promote endometrial growth
Immune dysfunction	Prevention of eliminating menstrual debris and promotion of implantation and growth of endometrial lesions
Apoptosis suppression	Promoting survival of endometrial cells and downregulation of apoptotic pathways
Genetic	Alteration of cellular function that increases attachment of endometrial cells and evasion of these cells from immune clearance
Stem cells	Initiation of endometriotic deposits by undifferentiated cells with natural ability to regenerate