What causes Endometriosis? Where we are in 2008.

As research into Endometriosis is gathering pace, it’s maybe worth having a look at some of the suggested reasons for endometriosis.  At the moment there is still no definitive answer, indeed there may be more than one cause – or a combination of causes.

One of the most promising theories is genetic.

There is extensive evidence that families where one person has endometriosis have a propensity for other female members to have this.  The biggest problem with this theory is that the actual cause is not explained.  Some families appear to have a high percentage of Endometriosis sufferer’s, whereas other families can have only one member over several generations.

This is complicated by the fact that only women with actual painful symptons tend to be available to base studies on, or ones who are having surgery which may lead to the discovery of endometriosis, without several comprehensive blind studies the genetic traits theory cannot be confirmed.


There is an increasing belief that exposure to pollutants and chemicals may be an underlying cause.  This has been backed up by several studies which indicate that exposure to dioxins may increase the chance of the endometriosis occuring.  How this occurs has not been explained consistently in these studies, however they have indicated that in areas where exposure to dioxins (pesticides and modern cleansing methods such as use of industrial scale bleaching products) endometriosis is higher.  This is also quoted as a reason why Endometriosis was effectively unknown until modern times, despite extensive anatomy records that date back further.



Blamed for many things – a hormonal imbalance has been suggested to be one of the causes, allowing the cells to grow and propagate more extensively – and therefore cause more problems – in women with a hormone imbalance.

There are ongoing studies in this matter and pharmacautical companies are continuing developing therapies to correct balances which they hope will be of use in treating endometriosis – or even those at risk from it.

Immune System problems

Often people with Endometriosis have indications of other Immune System problems, such as IBS, Chronic Fatigue, or just general bad health.  Some of this is attributed to dealing with the pain from Endometriosis which can run down the body. 

However the theory is that in those where endometrosis is causing the most pain – as the amount of endometriosis is known not to directly influence the pain a woman can feel. It is thought that a fully functioning immune system may well eliminate the endometrial cells which occur (possibly due to retrograde menstuation) – therefore it may be that endometriosis occurs more frequently than believed, but the body eliminates the cells before they implant.

When the immune system is damaged – or for some reason does not recognise the endometrial cells , then the endometriosis causes symptons etc..  This is also cited as a possible reason for some people being able to fight cancer cells more effectively than others, as some people’s body may recognise the rogue cells more readily and combat the spread.


As time passes progress is being made on endometriosis and hopefully, in the near future some of these theories will be put to the test and may be eliminated or expanded upon – and ultimately universal agreement of a cause, which may allow full and complete treatment of this disease.

Why do people get Endometriosis?

No one knows why people get endo, or what causes it. Perhaps one day these questions will have answers. Until then, research on endometriosis needs to continue to be done. Research is underway in several centres across the world looking for genes that may make people susceptable to endometriosis, if successful this may well hold the key to a cure or even a test to see if someone will get it in the near future!

Endometriosis May Have an Autoimmune Component

Source: Human Reproduction 2003; 18: 985–9

Human leukocyte antigen (HLA) systems may be involved in the etiology of endometriosis, indicates research conducted in Japan.

HLA genes have already been implicated in insulin-dependent diabetes mellitus, systemic lupus erythematosus, and pre-eclampsia, and women
with endometriosis have higher rates of autoimmune and other chronic diseases than do women in the general population.

To investigate the possibility of an autoimmune contribution to endometriosis, Keisuke Ishii (Niigata University School of Medicine, Japan) and co-workers genotyped 83 women with a laparoscopic diagnosis of the condition, looking specifically for the HLA-DQB1 and HLA-DBP1 alleles.

Ishii et al report that the prevalence of HLA-DQB1*0301 was 16.3 percent among patients versus 8.3 percent among 222 healthy male and female controls. This difference reached borderline statistical significance (odds ratio, 2.13).

In contrast, the prevalence of the HLA-DBP1 alleles was similar between patients and controls.
In 2002, Ishii’s group reported that HLA-DQB1*1403 was significantly more prevalent among patients with endometriosis than in controls, and this
is the first study to demonstrate a significant association between the two.

“Further investigations by increasing sample size and by replication in both Japanese and other populations are needed to fully understand the
association between HLA genes and this disease,” the team concludes.

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