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