Why and How does Endometriosis occur?

There is no definitive cause of endometriosis, however there are several hypotheses regarding how it develops. One possible mechanism is retrograde menstruation.

What is Retrograde Menstruation?⠀⠀⠀⠀⠀⠀⠀⠀⠀
The uterus is an ‘open ended’ organ – it has an opening at the bottom through the cervix and on the top on either side through the fallopian tubes. The fallopian tubes are not attached to the ovaries. So according to this hypothesis, during menstruation, when the blood is meant to exit the uterus through the cervix it can escape upward through the fallopian tubes as represented in the diagram above. This causes blood to spill over into the pelvic cavity which is where your bladder, ovaries and large intestine lie.

If there are other underlying issues such as estrogen dominance (these patients’ experience heavy menstrual bleeds or expel clots), the uterus may need to contract to push the blood and clots out. This action of contraction may cause some blood to escape from the uterus into the pelvic cavity through the fallopian tubes. With no drain in the pelvic cavity, the endometrial cells attach to various parts, bleed and grow on a monthly basis. Surrounding areas may become inflamed or swollen. Scar tissue and lesions may develop as a result.

Although a retrograde bleed might be part of the cause, treating the underlying issues such as estrogen dominance or heavy menstrual bleeding as well as dissolving existing endometriosis lesions and helping ease the pain patients go through is my aim in practice when treating this condition.

Another major factor that needs to be considered and treated is the chronic inflammation caused by endometriosis that occurs within the pelvic cavity. This inflammation, scar tissue and adhesions that form as a result are one of the reasons why women with endometriosis suffer with extreme pain and infertility.

Article written by Dr Tharushka Naidoo