Causes of endometriosis

Endome­trial cells should be located only in the uterine cavity. Their occur­rence in other areas of the body is a disorder called endome­trio­sis. Despite many years of research its exact causes have not yet been establi­shed. However, there are several theories on the aetio­logy of endome­trio­sis. They can be divided into three groups.

Transplantation and implantation theory

This theory proposes that menstrual blood flows retro­gra­dely from uterine cavity via the fallo­pian tubes into the pelvic cavity. This is where its cells are implanted into perito­neum or ovaries and other organs, creating endome­trial lesions. Accor­ding to this theory, endome­trial lesions may be trans­ferred also during the surgical proce­du­res, an example of which is endome­triosis in a cesa­rean section scar. The retro­grade menstru­ation occurs in almost all women with patent fallo­pian tubes, but not all of these women develop endome­triosis. Thus, other factors must play a role in the forma­tion of endome­triosis. This theory also does not explain the presence of endome­triosis in organs outside the abdominal cavity, e.g. in a lung.

Fig. Retrograde menstruation - one of the causes of endometriosis formation.

All women have reverse menstru­ation, but not in everyone endome­triosis develops. There­fore, other factors causing the disease must also be included.

Metaplasia theory

The second theory (Meyer’s theory) states that perito­neal cells can be trans­formed into endome­trial cells. This theory shows no connec­tion with retro­grade menstru­ation. On one hand, it explains the presence of endome­trial focuses on the pleura, because the embry­onic origin of both the pleura and the perito­neum and the endome­trium is common. On the other hand, if this postu­lates were correct, the incidence of pleural endome­triosis would be much higher than observed.

Induction theory

The third theory (Halban’s theory) says that unknown cells in the blood or lymph can trans­form into endome­trial cells and wander with blood to every part of the body. This would explain the presence of endome­trial foci in distant organs, such as the brain or lungs. However, this theory is at odds with the fact that the most common form of endome­triosis is endome­triosis in true pelvis, largely depen­dent on the circu­la­tion of fluid in the perito­neal cavity and gravity.

There­fore, most of facts support the first theory. In this perspec­tive why does not every woman develop endometriosis?

In our opinion...

In our opinion, each of the above theories is true but incom­plete. None of them give an answer to question "why?". It is true that most of women menstruate retro­gra­dely, especially those with narrowed cervix. Why then only some of them develop perito­neal implants and the other don’t?

The answer to this myste­rious question "why?" are most likely APOPTOSIS and IMMUNE SYSTEM. Genetics surely also plays a role, but we will ignore it here as we can not have an impact on it.

Fig. Origin of endometriosis - changed immune system the main cause of the disease.

Apoptosis

Apoptosis is a pro­grammed cell death designed to elimi­nate old, degene­rate and unneces­sary cells of the body, while not causing an inflam­ma­tory reaction. Thanks to apopto­sis, our body is purified and regene­ra­ted. In 2011, Dr. F. Taniguchi publi­shed an intere­sting scien­tific work "apop­tosis and endome­trio­sis", in which he described that apoptosis plays a key role in the creation of endome­trio­sis. How? Namely, he indicated that the endome­trium in the uterus of women with endome­triosis has higher expres­sion of the factors preven­ting apoptosis and decre­ased expres­sion of factors activa­ting apopto­sis. In women not suffe­ring from endome­triosis, the expres­sion of the above factors is reversed and shows cycli­ca­lity. It is inten­si­fied mainly in the period of menstrual period! Thus, the body of a healthy woman is equipped with great mecha­nisms to protect her from endome­trio­sis. This cycli­ca­lity is absent in women with endome­triosis!

It may sound a bit intri­ca­tely and scien­ti­fic, but we will try to trans­late it into a prac­tical langu­age, citing observa­tions of Dr. Fung, a neph­ro­lo­gist from the USA, who described his observa­tions in the book on thera­peutic fasting - "The Complete Guide to Fasting". It turns out that apoptosis is regulated hormo­nally. It is mainly about insulin and growth hormone. These are hormones which level can be modified in a very simple way. Namely, eating regularly every few hours (even small meals) and eating at the evenings results in constantly elevated insulin level (caused mainly by simple sugars and prote­ins). Insulin is a hor­mone that very effec­ti­vely inhibits apoptosis !!! On the other hand, stimu­la­ting effect on apoptosis is shown by the growth hormone, which concen­tra­tion is the highest at night. There­fore, it is often said that children should sleep well to grow. However, it should be also mentio­ned, that adults also need adequate amount of sleep in order to activate apopto­sis. Little is also said about giving up evening meals, which consump­tion incre­ases the level of insulin inhibi­ting growth hormone at the same time. This is why it is so impor­tant to intro­duce regular thera­peutic fasting in case of endome­triosis - you can read more about it in section devoted to nutri­tional therapy!

Changed immune system in women with endometriosis

Dr M. Kyama publi­shed the results of his research on the impact of immune system on endome­triosis in “Re­pro­­du­c­tive biology and endocri­­no­­lo­gy”. It appears that women with endome­triosis show a disturbed cellular immune response. The malfunc­tion especially of natural killer (NK) cells, helps to keep the implants of the endome­triotic cells which migrated retro­gra­dely from the uterus to abdominal cavity through fallo­pian tubes. If it was not enough, the disturbed immune cells can not pass the infor­ma­tion that stimu­lates apoptosis to endome­trial cells in the abdomen!

Summary

Apart from the clichéd theories concer­ning etiology of endome­trio­sis, it seems that the main role is played by im­pa­ired apoptosis and the distur­bances within immune system. It results in organism "tole­rance" towards cells arriving from the uterus to the abdominal cavity and enables them to implant in abdominal organs covered with a wel­l-va­scu­la­rized perito­neum, which nouri­shes them and allows their growth.

What can be done about it? Hormonal suppres­sion (so-called artifi­cial menopause) can be used to treat endome­trio­sis. However, it inhibits ovula­tion simul­ta­ne­ously preven­ting pregnancy. Such treat­ment is also not indif­fe­rent to the organism. Heada­ches, migra­ines, throm­bo­sis, decre­ased libido, depres­sive states are just some of the undesi­rable effects of this type of therapy.

We support the treat­ment of the actual cause of the disease. In case of endome­triosis the goal is to activate apoptosis and restore the proper function of the immune system. Apoptosis can be stimu­lated by chan­ging eating habits and healthy intestin is a guarantor of the proper function of the immune system. For details, please visit our nutri­tional therapy section.

Wondering if you also have endometriosis?

The sooner you diagnose this disease, the more likely you are to cure it completely. It means not only a better quality of life due to the lack of menstrual ailments, but also a restoration of your natural fertility.