Causes of endometriosis

Written by Xu Xiao Ming
Obstetrics and Gynecology
Updated on April 18, 2025
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The causes of endometriosis are not yet fully understood, but the theory of endometrial implantation is recognized by most experts and scholars. The main reason is that during menstruation, endometrial glandular epithelium and stromal cells can retrograde with menstrual blood, enter the pelvic cavity through the fallopian tubes, implant on the ovaries and adjacent pelvic peritoneum, and grow and spread there, forming pelvic endometriosis. Most clinical and experimental data also support this theory, indicating that approximately 70%-90% of women experience menstrual blood retrograde. Additionally, congenital vaginal atresia can also lead to endometriosis, as well as iatrogenic endometrial implantation, such as abdominal scar implantation after cesarean section or endometriosis at the perineal incision site after childbirth. These factors may also contribute to the development of endometriosis.

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Written by Liu Wei Jie
Obstetrics
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Can endometriosis turn into cancer?

The answer is no. First, let's explain what endometriosis is. Endometriosis is when the endometrium, or the lining of the uterus, is found outside of its normal location, including in the muscular layer of the uterus, the ovaries, the pelvic cavity, or the intestines; it can occur in any of these areas. This condition is known as endometriosis. Endometriosis within the uterus is a benign condition, but it can lead to severe painful menstruation and chocolate cysts. If the menstrual pain is very severe, there may be a possibility of needing a hysterectomy in the future. If a chocolate cyst occurs, surgery might also be necessary.

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Written by Zhang Lu
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Causes of Infertility in Endometriosis

Endometriosis is a common gynecological disease that severely troubles women's daily lives. Besides causing painful menstruation, endometriosis is also a common cause of infertility. The reasons for infertility caused by endometriosis include the following aspects: First, endometriosis often leads to the formation of chocolate cysts on the ovaries, which can affect ovarian function and cause impaired ovarian function. Second, endometriosis can sometimes affect the function of the fallopian tubes, causing adhesions in the fallopian tubes. This may result in difficulties in egg pickup, preventing the sperm and egg from meeting and forming a fertilized egg in the fallopian tubes, leading to infertility.

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Written by Li Shun Hua
Obstetrics and Gynecology
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How is endometriosis treated?

The treatment methods for endometriosis depend on the patient's age, the severity of symptoms, and whether they have childbearing requirements. For younger patients who wish to have children, conservative treatment methods are preferable, followed by ovulation induction therapy. For older patients with more severe symptoms, surgical treatment may be considered. If the patient does not have immediate childbearing requirements, a hormonal intrauterine device (IUD) can be placed in the uterus. This device releases progesterone and provides excellent treatment results for endometriosis. If the symptoms of endometriosis are severe, manifesting in pronounced dysmenorrhea, excessive menstrual bleeding, or ovarian cysts, then surgical treatment should be considered.

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Written by Zhang Xiu Rong
Obstetrics and Gynecology
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Does endometriosis cause pain?

The clinical feature of endometriosis is painful menstruation, which tends to worsen over time. If the endometrial tissue is displaced to the ovaries, it can lead to the formation of ovarian endometriomas, often called "chocolate cysts", which can cause the ovaries not to release eggs and generally affects fertility. If endometrial tissue displaces to the uterus, it can cause adenomyosis, leading to a uniformly thickened uterine muscle layer and uneven muscle wall echoes, resulting in an enlarged uterus, which also impacts fertility. Therefore, it is crucial for patients with endometriosis to seek early treatment and prepare for pregnancy as soon as possible. Endometriosis, which affects fertility, is typically characterized by painful menstruation that gradually worsens, and generally, painkillers are insufficient for treating this condition.

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Written by Zhang Lu
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Is it easy to get pregnant with endometriosis?

Endometriosis, which has a relatively high incidence among women, refers to the condition where the endometrial tissue is located outside the uterine cavity. This condition can easily lead to infertility. Although endometriosis is a benign disease, it exhibits characteristics similar to those of malignant diseases, primarily manifesting as local infiltration that causes adhesions and can disrupt the function of the fallopian tubes and ovaries. First, it can lead to the presence of chocolate cysts on the ovaries, which can affect the ovulation function of the ovaries. Second, it can sometimes cause adhesions in the fallopian tubes or pelvic adhesions, affecting the egg-pickup function of the fallopian tubes. This prevents sperm and eggs from fertilizing within the fallopian tubes. Even if fertilization occurs, the impaired function of the fallopian tubes may also lead to an increased risk of ectopic pregnancy.