Pathogenesis (development of disease)
Endometriosis is now also evaluated as a systemic disease.
The cause and mechanism of development of endometriosis are largely unclear. Several theories have been developed:
- Transplantation theory – This assumes that during menstruation endometrial tissue enters the abdominal cavity retrogradely (“retrograde”) via the tubes (fallopian tubes), or is carried away via the bloodstream or lymphatic system or during surgery.
- Metaplasia theory – This theory assumes that endometriosis lesions form in situ from embryonic pluripotent abdominal cells (stem cells that have the ability to form into cells of the three germ layers (ectoderm, Entoderm, Mesoderm) and the germ line of an organism), develop the so-called celomic epithelium (tissue that lines the secondary body cavity (celom) and forms pleura (pleura), peritoneum (peritoneum) and pericardium (pericardium)).
- Induction theory – It represents a combination of the transplantation and metaplasia theories.
- Immunological theory – This theory describes a possible immunodeficiency of the affected women.
- Tissue Injury And Repair theory (TIAR) – In this theory, increased peristalsis of the uterus leads to microtrauma (small damage) in the myometrium (uterine muscles). In the reparative mechanism, estrogens are released locally (“locally”), which in turn increase peristalsis and thus trauma.
- Varia – Other theories assume, for example, genetic (two possibly contributory defects have recently been found), cellular, molecular, vegetative and other mechanisms.
Etiology (causes)
Environmental exposure – intoxications (poisonings).
- Beta-HCH (by-product of lindane manufacture).
- Mirex (insecticide)
