Pathogenesis of Endometriosis and Future Approaches

Endometriosis is an estrogen-dependent female disease associated with pelvic pain and infertility as a result ofabnormal placement of endometrial tissue outside the uterus.Endometriosis, which affects approximately 200million women worldwide, continues to be an important health problem today due to its uncertainties about itspathogenesis. Since the disease was identified, many different pathogenetic pathways have been considered,such as retrograde menstruation, benign metastasis, immune disorders, hormonal imbalances, involvement ofstem cells, and changes in epigenetic regulation. Interaction of the number and amount of menstrual flows withgenetic and environmental factors seems to determine the likelihood of development as well as the phenotypicmanifestation of the disease However, the true pathogenesis of endometriosis is not fully understood. Therefore,in this review, we outline recent developments that illuminate the main origin and pathogenesis of endometriosisbased on current studies and provide new avenues for research that promises to improve early diagnosis andtreatment of endometriosis. Although endometriosis is generally thought to be a steroid-sensitive disease, one ofthe possible causes of the development of endometriosis may be the immune system. A thorough understandingof the histopathogenesis and pathophysiology of endometriosis is essential for the development of newdiagnostic and therapeutic approaches to this debilitating condition.