What is causing endometriosis is not known. The disease is very enigmatic and poorly understood. Many theories have been proposed, However, none is able to explain all the symptoms, the presentations and the evolution of the disease.


The most acceptable explanation is that of retrograde menstruation. It was proposed by Dr. John Simpson, who was the first to recognize and report the condition. During menstruation, the endometrium is shed off the uterus with the menstrual blood. Small pieces of endometrium flow into the opposite direction and enter the abdominal cavity through the tubes. They stick onto various organs and develop into the endometriotic lesions.


This theory can not explain why only some of the 90% of women with retrograde menstruation, will develop endometriosis.


It can also not explain the appearance of endometriosis in women with blocked tubes, or those who have undergone an hysterectomy.


The immunological theory tries to explain, why not all women with retrograde menstruation will develop endometriosis.


It is suggested, that the presence or absence of one or more immunological factors may protect or expose a woman to the development of the disease.


It is not well understood if the immunological disturbances seen in women with endometriosis are the cause or the result of the disease.


The genetic theory tries to establish why the appearance of endometriosis is more common in certain families than others.


The environmental theory maintains that certain environmental toxic factors, such as dioxins, disrupt the hormonal and immune function of the body and expose it to the development of endometriosis. The scientific evidence is not sufficient yet.


We need a lot of imagination in trying to explain the rare appearance of endometriosis in places such as the lungs, the eyes, the brain or even in men who have been treated with estrogens for prostatic cancer!



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