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Expert Definition

Understanding This Symptom

Medical Definition

Subject Matter Expert Verified

Endometriosis is a chronic, estrogen-dependent gynecological condition characterized by the presence of ectopic endometrium (endometrial-like tissue) growing outside the uterine cavity, most commonly on the ovaries, fallopian tubes, pelvic peritoneum, and uterosacral ligaments.

This misplaced tissue responds to menstrual cycle hormones, causing cyclic inflammation, scarring, adhesions, and severe pelvic pain, affecting approximately 190 million women worldwide.

Quick Facts

Expert-reviewed by medical professionals
Based on current medical research
Updated for 2026 standards

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Healthy State

What Optimal Health Looks Like

Understanding how your body functions when healthy helps identify dysfunction

Healthy endometrial tissue lines the interior of the uterus, undergoing monthly cyclic changes in response to hormonal fluctuations.

During a normal 28-day menstrual cycle: estrogen stimulates endometrial proliferation (days 1-14), ovulation occurs around day 14, progesterone transforms the endometrium into a secretory receptive state (days 15-28), and menstruation occurs when progesterone levels drop if no fertilization occurs.

The menstrual flow exits through the cervix and vagina via retrograde menstruation, but the immune system clears any endometrial cells that enter the pelvic cavity.

Healthy pelvic anatomy includes normal uterine position, patent fallopian tubes, and peritoneal surfaces free of adhesions or scarring.

Healthy Function

Your body is designed to maintain balance and self-regulate

Optimal Range
Development Process

How This Develops

1

Retrograde Menstruation (Sampson's Theory) - Menstrual blood containing endometrial cells flows backward through the fallopian tubes into the pelvic cavity, implanting on peritoneal surfaces and organs; (

2

Coelomic Metaplasia - Peritoneal cells undergo metaplastic transformation into endometrial tissue due to hormonal or inflammatory stimuli; (

3

Embryonic Rest Theory - Müllerian duct remnants differentiate into endometrial tissue; (

4

Estrogen Dependence - Endometriotic lesions express higher estrogen receptors and produce estradiol locally via aromatase, creating a self-perpetuating estrogenic environment; (

5

Immune Dysregulation - Impaired NK cell function and macrophage activity fail to clear ectopic cells; (

6

Inflammation and Cytokines - Elevated IL-

7

Angiogenesis - VEGF promotes blood vessel formation to nourish implants; (

8

Adhesion Formation - Chronic inflammation leads to fibrin deposition, scarring, and tissue adherence between organs; (

9

Neural Ingrowth - Endometriotic lesions develop their own nerve fibers, amplifying pain signals; (

10

Chocolate Cyst Formation - Endometrial tissue in ovaries forms blood-filled cysts (endometriomas) that darken over time

Understanding the mechanism helps us target the root cause rather than just treating symptoms.

Cost of Waiting

What Happens If Left Untreated

Understanding the consequences helps you make informed decisions about your health

Short-Term Consequences

Days to weeks

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Time Matters

Don't wait for symptoms to worsen. Early intervention leads to better outcomes.

Common Questions

Frequently Asked Questions

Expertise Behind This Guide

Evidence-Based Information

Dr. Hafeel Afsar, DHA Licensed Integrative Medicine

References & Further Reading

Zondervan KT, Becker CM, Missmer SA. Endometriosis. New England Journal of Medicine. 2020;382(13):1244-1256. doi:10.1056/NEJMra1914704
Taylor HS, Kotlyar AM, Flores VA. Endometriosis is a chronic systemic disease: clinical challenges and novel insights. Nature Medicine. 2021;27(2):218-229. doi:10.1038/s41591-021-01265-5
American College of Obstetricians and Gynecologists. Practice Bulletin No. 114: Management of Endometriosis. Obstetrics & Gynecology. 2010;116(1):223-236. doi:10.1097/AOG.0b013e3181e8b073

This information is for educational purposes and not a substitute for professional medical advice.