What is endometriosis?
Endometriosis is a chronic condition affecting 1 in 10 female born at global level, however due to misdiagnosis and other factors, the exact prevalence of endometriosis is unknown. On average it takes between 8-10 years until a diagnosis is made from the start of the symptoms. Is a whole body disease, underdiagnosed and undertreated all over the world.
Known as gynaecological pathology, in many cases, endometriosis affects multiple areas and organs in the body. Endometriosis tissues come in different shapes and colours. The pelvis is the area most affected by endometriosis, but the abdomino-thoracic area can also be frequently affected.
Endometriosis can affect the peritoneum of the pelvic organs, the ligaments, the pouch of Douglas, the intestines, the urinary tract, the appendix, the ovaries, the fallopian tubes, the external surface of the uterus, the nervous system, but also organs in the upper abdomen, such as the diaphragm, the lungs, the kidneys, etc. The latter are classified as rare forms of endometriosis.
Definition of endometriosis
Endometriosis is a benign inflammatory condition defined by the presence of endometrial-like tissue (glands and stroma) outside the uterus. Studies that have looked at endometriotic tissue and endometrial tissue show that the two tissues are not identical. Considered a condition of women of childbearing age, endometriosis has been found in foetuses, newborns, young girls and menopausal women. It has also been found in men and animals.
The exact cause of endometriosis is so far unknown, however there are various theories around the origin of it. Among the most well-known theories are the theory of retrograde menstruation and the theory of Muleriosis. Other theories regarding the formation of endometriosis are:
- coelomic metaplasia – refers to the transformation of coelomic cells into endometriosis tissue in response to unknown stimuli;
- environment- suggests that airborne toxins such as dioxin may cause endometriosis;
- genetic – according to some studies there is an increased risk for endometriosis among first and second degree relatives;
Theories of endometriosis
Retrograde menstruation
This theory originated in 1921, its author being Dr John A Sampson and is the most well-known theory. As a result of this theory, endometriosis is considered a menstrual disease, affecting only women of childbearing age.
The theory of retrograde menstruation states that during monthly menstruation some of the menstrual blood containing endometrial tissue returns to the uterus and reaches the pelvis through the fallopian tubes. Once in the pelvis, these tissues spread over the surfaces of the pelvis where they attach, implant, grow and develop into endometriosis.
NOTE: At COPE Clinics we believe that this theory does not explain extrapelvic endometriosis as such it is not reflected in our treatment methods.
Embryonic theory or Muleriosis theory
This theory states that endometriosis is caused by a developmental defect in the differentiation or migration of any cellular component of the Mullerian duct, or of the coelomic epithelial lining of the adult peritoneum, from which the ductal system and peritoneum originate.