Endometriosis Questions and Answers - Treatments - Diagnosis - Support Groups -

What causes endometriosis?

A number of theories have been advanced, but no single theory explains all cases of endometriosis. For example, the most popular theory is called the Retrograde Menstruation Theory (promoted by Dr. John Sampson in the 1920's). He surmised that menstrual tissue flows backwards through the fallopian tubes and deposits on the pelvic organs where it seeds and grows. Later, researchers found that most women have retrograde flow. But since most women don't develop endometriosis, some doctors have concluded that an immune system dysfunction or hormonal problem may be a trigger. The Retrograde Menstruation Theory doesn't explain how endometriosis develops in women who've had a hysterectomy or their tubes tied. It also doesn't explain the fact that in rare cases, men have developed endometriosis when they've been treated with estrogen after prostate surgery.

Other theories have been proposed by other researchers. The Genetic Theory suggests that women may have a genetic predisposition to developing endometriosis. Studies by researchers such as Dr. Stephen Kennedy at Oxford University show that first- degree relatives of women with this disease are more likely to develop endometriosis. And when there is a hereditary link, the disease tends to be worse in the next generation.

Other theories assert that endometrial fragments travel through the bloodstream or the lymphatic system to other parts of the body. This may explain how endometriosis ends up in the lung, brain, skin, or eye. Still others believe that misplaced embryonic cells cause endometriosis, or that some adult cells retain the ability they had in the embryonic stage to transform into reproductive tissue. Endometriosis has been found in surgical scars which is probably caused by transplantation of endometrial tissue during surgery.

Research conducted by Dr. Sherry Rier and sponsored by the Endometriosis Association shows a link between dioxin exposure and the development of endometriosis. Dr. Rier and her colleagues discovered that 79% of the monkeys exposed to dioxin developed endometriosis. Further, the monkeys who had the most exposure had the most extensive endometriosis. The findings were published in the study entitled, Endometriosis in rhesus monkeys following chronic exposure to 2, 3, 7, 8- tetrachlorodibenzo- p- dioxin, published in Fundamental and Applied Toxicology 21:433-441, 1993. Read an abstract of a similar paper by Dr. Rier published in Environmental Health Perspectives.

Dioxins are part of the organochlorine group of chemicals. Studies have shown that organochlorines act as hormones in our bodies. Dioxin is created by incinerators burning chlorinated waste, leaded gas, and in the manufacture of pesticides, solvents, and PVC plastics. Dioxin can be found in bleached products. Most alarming, dioxin may be found in women's sanitary products except those manufactured specifically without dioxins. An interesting site called S.P.O.T. has more information about the connection between dioxins and tampons. Those really interested in the endocrine disrupter topic should visit the EPA's site .

How many women are affected by endometriosis?

The exact number is unknown. However, the Endometriosis Association estimates the disease affects 5.5 million women in the United States and Canada and many millions more throughout the world. Endometriosis is an equal- opportunity disease, affecting every nationality fairly equally. Even though endometriosis affects millions of women and is the leading cause of pelvic pain, it remains one of the most poorly understood conditions of our time.

What are some of the warning signs which may indicate endometriosis?

First, you have to understand that endometriosis is a very sneaky and elusive disease. It refuses to live by any rules, so it can manifest itself in a variety of ways. Because the location of the lesions have a great deal to do with the symptoms, each woman's symptoms will vary. In general, though, some of the hallmark symptoms of endometriosis include pelvic pain, pain before and/or after menstruation, severe menstrual cramps (the kind that require more than a few aspirin), painful intercourse, painful orgasms, heavy or irregular menstrual bleeding, painful bowel movements (often involving cycles of diarrhea and constipation), infertility, intestinal distress (bloating, vomiting, nausea), lower back pain which may radiate down the legs, bladder pain and/or frequency, and fatigue. However, some women with endometriosis don't have any symptoms and may not know they have endometriosis until a problem, such as infertility, is discovered. Interestingly, the extent of endometriosis has no correlation to the amount of pain a woman will experience.