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 Xu Xiao Ming
Obstetrics and Gynecology
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Causes of endometriosis

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 Zhang Xiu Rong
Obstetrics and Gynecology
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Endometriosis Clinical Manifestations

Endometriosis is clinically most evident in dysmenorrhea, which tends to worsen progressively. The clinical presentation varies depending on where the endometrial tissue is located. If the tissue is located on the ovaries, it can form ovarian chocolate cysts. Generally, chocolate cysts can affect fertility, leading to anovulation and the appearance of ovarian chocolate-like cysts. Treatment typically involves surgical intervention, which is characterized by a high risk of recurrence after surgery. If there is no immediate plan for pregnancy, there is also a possibility of recurrence. Additionally, if endometriosis involves the uterus, it can lead to a uniformly enlarged uterus and uneven uterine wall echoes, resulting in adenomyosis. Therefore, the most typical clinical manifestation of endometriosis is progressively worsening dysmenorrhea.

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

Treatment methods for endometriosis include conservative treatment and surgical treatment. If the patient's symptoms are relatively mild, the dysmenorrhea is not very severe, and there is no occurrence of excessive menstruation or prolonged menstrual period, conservative treatment can be applied. Common conservative treatment methods include oral contraceptive pills, and a levonorgestrel-releasing system can be placed inside the uterine cavity. If the patient has reproductive demands and the symptoms are more severe, or if there is a chocolate cyst on both ovaries, surgical treatment can be performed, but the recurrence rate after surgery is also relatively high. (The use of medication should be under the guidance of a doctor.)

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Written by Wang Jing Hua
Obstetrics and Gynecology
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Can endometriosis be cured?

The treatment of endometriosis should be determined based on the individual's specific circumstances. Complete cure typically requires the removal of both ovaries. As long as the ovaries are present, there generally is no talk of a complete cure; treatment can only control the condition. It is possible to surgically remove lesions and use medication to reduce the likelihood of recurrence. The specific treatment for endometriosis should be determined based on factors such as age, whether there is a desire for children, and specific symptoms like painful periods and bleeding conditions.

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Written by Zhang Hui
Obstetrics and Gynecology
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How many days does the pain from endometriosis last?

Endometriosis refers to the condition where active endometrial cells implant outside the uterine lining. It is a relatively common gynecological disease. Pain usually begins one to two days before menstruation starts, is most severe on the first day of menstruation, and gradually lessens thereafter. The pain generally persists throughout the menstrual period. It is advised that patients with endometriosis seek timely treatment under the guidance of a clinical doctor, based on their individual conditions, to prevent the progression of the disease and serious health consequences.