Endometriosis Theories and Concepts

There are many theories and concepts regarding
endometriosis that can help in understanding
endometriosis.  An endometriosis theory may be useful
at several levels including guiding research in treatment,
acting as a framework for education, explaining why a
treatment works, and studying endometriosis.  However,
a theory does not determine if a treatment works.  
Treatment should be based on evidence of its success.  
Discussions of how theory or the general limitations of
knowledge can interfere with treatment are in the file.

Theories and concepts can be divided into the cell of
origin and the pathophysiologic transition from an original
endometrial cell to endometriosis

The Cell of Origin

Dissemination / Metastasis
  Retrograde Menstruation
  Hematogenous Dissemination
  Lymphatic Dissemination
  Traumatic / Surgical Dissemination

Müllerian Theories
  Müllerian Remnants (any congenital)
  Müllerianosis (organoid)
  Mülleriosis (non-organoid and transitional)
  Secondary Müllerian System

Metaplastic Theories
  Peritoneal / Mesenchymal Stem Cells
  Bone Marrow Stem Cells
  Endometrial Stem Cells

Transition from endometrium to endometriosis

The transition involves the local environment,
inflammation, epigenetic changes, genetic changes
progenitor cell differentiation, biochemical changes
immunologic changes, apoptosis, autophagy,
reactive oxygen species, fibrosis, muscular
metaplasia, macrophage migration inhibitor
factor, clonality, microRNA, signaling, nerve
activation, cancer-associated driver mutations,
fibroblast to myofibroblast transdifferentiation,
neurogenesis, angiogenesis, genetic dysregulation
and more that are covered in the
PDF.

No theory is completely adequate.  Of the more than 80
theories and concepts covered in the PDF, it generally
takes seven to discuss what I have seen and many more
to introduce what I have read.  Since theories change, the
PDF “
Endometriosis Theories and Concepts” will be
periodically updated.