What is
ENDOMETRIOSIS?

When a patient presents to a specialist doctor with pelvic pain, and pain during menstruation, endometriosis should be considered as a cause. This should be considered as a primary diagnosis, not the last one, the way it often happens. Since endometriosis is complex and its symptoms mimic other pathologies, the diagnosis is delayed. It is estimated that from the onset of the symptoms until receiving a correct diagnosis, women wait on average between 7 and 10 years.

Endometriosis is a whole-body disease, (Nezhat C), and is associated with pelvic pain and infertility. Symptoms can range from mild to severe and in some cases endometriosis can be asymptomatic. Endometriosis pain is, in most cases, close to unbearable. It is visceral and debilitating.

Endometriosis is a benign medical condition believed to be estrogen dependent; however, studies show that endometriosis tissues have progesterone receptors as well. And also, it produces its own estrogen.

It is a common disease affecting almost 200 million people around the world and due to some symptoms that correlate with other diseases, it’s often misdiagnosed. It was included in the 20 most painful conditions by the NHS UK, and if it is not treated on time, it can potentially cause organ loss and disability.

Endometriosis is a benign medical condition believed to be estrogen dependent; however, studies show that endometriosis tissues have progesterone receptors as well. And also, it produces its own estrogen.

It is a common disease affecting almost 200 million people around the world and due to some symptoms that correlate with other diseases, it’s often misdiagnosed. It was included in the 20 most painful conditions by the NHS UK, and if it is not treated on time, it can potentially cause organ loss and disability.

The exact cause of endometriosis is not known so far. A few theories have been presented, and the pathophysiology is likely to be multifactorial. Since the exact cause of endometriosis remains unknown, excision surgery is the only curative method, in a single or a second surgery.

John Sampson tried to understand what is endometriosis. Sampson’s theory of reflux menstruation, also known as the implantation or transplantation theory, is one of the oldest theories about how endometriosis tissues develop. Each month the lining of the uterus is shed, resulting in what is known as menstruation.

Sampson’s theory suggests that the lining of the uterus (endometrial cells) rather than leave the body, flows back into the body through the fallopian tubes, where it can implant and attach itself to different areas and organs, causing the development of endometriosis. Once attached and implanted, these cells act as the endometrium during menstruation, they shed and bleed.

This theory has not been disproven by research and it does not match the fact that endometriosis was found in young girls, men, fetuses, and animals. Based on the history of endometriosis, when Sampson published his first data, the term endometriosis did not exist. In 1921, Sampson published a study done on 23 women, and only 9 cases were histologically proved endometrial type ovarian cysts.

Mülleriosis, Dr David Redwine’s current theory of the origin of endometriosis, refers to a developmental defect in the differentiation or migration of any cellular component of the müllerian duct system, or of the coelomic epithelial anlage of the adult peritoneum, from which both the müllerian ducts and peritoneum arise. (Endopeadia).

The mulleriosis theory is different from Sampson’s Mullerianosis. Dr. Redwine’s theory is supported by fetal autopsy. Endometriosis forms during fetal development. The autopsy was done on 36 human female fetuses at different gestational ages, and four of them had misplaced endometrium in several sites such as the rectovaginal septum, cul-de-sac, and posterior wall of the uterus.

This theory also explains the cases of endometriosis in males and animals and the presence of endometriotic tissues distant from the pelvis.