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Causes

By Mayo Clinic staff

Although the exact cause of endometriosis is not certain, several possible explanations include:

  • Retrograde menstruation. This is the most likely explanation for endometriosis. In retrograde menstruation, menstrual blood containing endometrial cells flows back through the fallopian tubes and into the pelvic cavity instead of out of the body. These displaced endometrial cells stick to the pelvic walls and surfaces of pelvic organs, where they grow and continue to thicken and bleed over the course of each menstrual cycle.
  • Embryonic cell growth. The cells lining the abdominal and pelvic cavities come from embryonic cells. When one or more small areas of the abdominal lining turn into endometrial tissue, endometriosis can develop.
  • Surgical scar implantation. After a surgery, such as a hysterectomy or C-section, endometrial cells may attach to a surgical incision.
  • Endometrial cells transport. The blood vessels or tissue fluid (lymphatic) system may transport endometrial cells to other parts of the body.
  • Immune system disorder. It's possible that a problem with the immune system may make the body unable to recognize and destroy endometrial tissue that's growing outside the uterus.
Risk factors Symptoms
References
  1. Endometriosis. The National Women's Health Information Center. http://www.womenshealth.gov/publications/our-publications/fact-sheet/endometriosis.html. Accessed March 5, 2013.
  2. Schenken RS. Pathogenesis, clinical features, and diagnosis of endometriosis. http://www.uptodate.com/home. Accessed March 5, 2013.
  3. Frequently asked questions. Gynecological problems FAQ013. Endometriosis. American College of Obstetricians and Gynecologists. http://www.acog.org/~/media/For%20Patients/faq013.pdf?dmc=1&ts=20130305T1348596508. Accessed March 5, 2013.
  4. Pain management of endometriosis. American College of Obstetricians and Gynecologists. http://www.acog.org/About_ACOG/News_Room/News_Releases/2010/Pain_Management_of_Endometriosis. Accessed March 5, 2013.
  5. American College of Obstetricians and Gynecologists (ACOG) Committee on Practice Bulletins — Obstetrics. ACOG Practice Bulletin No. 114: Management of endometriosis. Obstetrics & Gynecology. 2010;116:223.
  6. What is assisted reproductive technology? Centers for Disease Control and Prevention. http://www.cdc.gov/art/index.htm. Accessed March 5, 2013.
  7. Schenken RS. Overview of the treatment of endometriosis. http://www.uptodate.com/home. Accessed March 5, 2013.
  8. Schrager S, et al. Evaluation and treatment of endometriosis. American Family Physician. 2012;87:107.
  9. Pearce CL, et al. Association between endometriosis and risk of histological subtypes of ovarian cancer: A pooled analysis of case-control studies. The Lancet Oncology. 2012;13:385.
  10. Gallenberg MM (expert opinion). Mayo Clinic, Rochester, Minn. March 8, 2013.
  11. Bakkum-Gamez JN (expert opinion). Mayo Clinic, Rochester, Minn. March 13, 2013.
DS00289 April 2, 2013

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