About Endometriosis

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Endometriosis is a complex and multifactorial disease, and its exact causes are still not fully understood G Signorile et al., 2023. However, several factors are thought to contribute to its development, including hormonal imbalances, genetic predisposition, and environmental factors G Signorile et al., 2022.

One of the main theories is that endometriosis is caused by retrograde menstruation, where menstrual blood flows back through the fallopian tubes and into the pelvic cavity, leading to the implantation of endometrial tissue outside the uterus G Signorile et al., 2023. This theory is supported by the fact that endometriosis is more common in women who have a family history of the disease, suggesting a possible genetic component G Signorile et al., 2022.
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Hormonal imbalances, particularly an excess of estrogen, are also thought to play a role in the development of endometriosis Vannuccini et al., 2021. Estrogen stimulates the growth of endometrial tissue, and an imbalance of estrogen and progesterone can lead to the proliferation of endometrial cells outside the uterus A MacLean 2nd & Hayashi, 2022.
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In addition, inflammation is also thought to play a role in the development of endometriosis Krygere et al., 2025. Cytokines, which are proteins that promote inflammation, have been found to be elevated in women with endometriosis, and may contribute to the growth and maintenance of endometrial lesions Aksak et al., 2020.
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Other factors that may contribute to the development of endometriosis include coelomic metaplasia, where cells in the pelvic cavity transform into endometrial cells, and stem cell involvement, where stem cells in the pelvic cavity differentiate into endometrial cells G Signorile et al., 2023.
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Overall, the exact causes of endometriosis are still not fully understood, and it is likely that the disease is the result of a combination of genetic, hormonal, and environmental factors G Signorile et al., 2022.
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In terms of food sensitivities, some studies have suggested that a gluten-free diet may be beneficial for women with endometriosis Brouns et al., 2023, although the evidence is not yet conclusive P van Haaps et al., 2024. Other dietary factors, such as a high intake of dairy products, may also be associated with a reduced risk of endometriosis Qi et al., 2021.
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In conclusion, while the exact causes of endometriosis are still not fully understood, hormonal imbalances, genetic predisposition, and environmental factors are thought to contribute to its development. Further research is needed to fully understand the causes of endometriosis and to develop effective treatments for the disease.

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References

Cited References:
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G Signorile, P., Baldi, A., Viceconte, R., Ronchi, A., & Montella, M. (2023). Pathogenesis of endometriosis: focus on adenogenesis-related factors.. In Vivo (Athens, Greece). https://doi.org/10.21873/invivo.13288
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G Signorile, P., Viceconte, R., & Baldi, A. (2022). New insights in pathogenesis of endometriosis.. Frontiers In Medicine. https://doi.org/10.3389/fmed.2022.879015
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Vannuccini, S., Clemenza, S., Rossi, M., & Petraglia, F. (2021). Hormonal treatments for endometriosis: the endocrine background.. Reviews In Endocrine & Metabolic Disorders. https://doi.org/10.1007/s11154-021-09666-w
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A MacLean 2nd, J. & Hayashi, K. (2022). Progesterone actions and resistance in gynecological disorders.. Cells. https://doi.org/10.3390/cells11040647
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Krygere, L., Jukna, P., Jariene, K., & Drejeriene, E. (2025). Diagnostic potential of cytokine biomarkers in endometriosis: challenges and insights.. Biomedicines. https://doi.org/10.3390/biomedicines12122867
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Aksak, T., Gümürdülü, D., Turan Çetin, M., & Polat, S. (2020). Expression of monocyte chemotactic protein 2 and tumor necrosis factor alpha in human normal endometrium and endometriotic tissues.. Journal Of Gynecology Obstetrics And Human Reproduction. https://doi.org/10.1016/j.jogoh.2020.101971
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Brouns, F., Van Haaps, A., Keszthelyi, D., Venema, K., Bongers, M., Maas, J., & Mijatovic, V. (2023). Diet associations in endometriosis: a critical narrative assessment with special reference to gluten.. Frontiers In Nutrition. https://doi.org/10.3389/fnut.2023.1166929
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P van Haaps, A., Brouns, F., Anneke M F Schreurs, A., Keszthelyi, D., Jacques W M Maas, J., & Mijatovic, V. (2024). A gluten-free diet for endometriosis patients lacks evidence to recommend it.. AJOG Global Reports. https://doi.org/10.1016/j.xagr.2024.100369

Qi, X., Zhang, W., Ge, M., Sun, Q., Peng, L., Cheng, W., & Li, X. (2021). Relationship between dairy products intake and risk of endometriosis: a systematic review and dose-response meta-analysis.. Frontiers In Nutrition. https://doi.org/10.3389/fnut.2021.701860
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Relevant but not cited:
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Rzewuska, N., Kunicki, M., Mechsner, S., & Kordowitzki, P. (2023). Rare clinical presentation of postmenopausal endometriosis: a new perspective.. Aging And Disease. https://doi.org/10.14336/AD.2023.1022
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Secosan, C., Balulescu, L., Brasoveanu, S., Balint, O., Pirtea, P., Dorin, G., & Pirtea, L. (2020). Endometriosis in menopause-renewed attention on a controversial disease.. Diagnostics (Basel, Switzerland). https://doi.org/10.3390/diagnostics10030134

Fiala, L., Lenz, J., & Bob, P. (2021). Effect of psychosocial trauma and stress on sexual dysfunction in women with endometriosis.. Medicine. https://doi.org/10.1097/MD.0000000000026836
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Vallée, A., Carbonnel, M., Ceccaldi, P., Feki, A., & Ayoubi, J. (2024). Postmenopausal endometriosis: a challenging condition beyond menopause.. Menopause (New York, N.Y.). https://doi.org/10.1097/GME.0000000000002338

Voltolini Velho, R., Werner, F., & Mechsner, S. (2023). Endo belly: what is it and why does it happen?-a narrative review.. Journal Of Clinical Medicine. https://doi.org/10.3390/jcm12227176
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R Guimarães Ferreira, L., Cavalcanti, T., Zomer, M., Kondo, W., Araujo Júnior, E., & Kulak Junior, J. (2021). Estrogen and progesterone receptors in endometriosis.. Minerva Obstetrics And Gynecology. https://doi.org/10.23736/S2724-606X.21.04888-0
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Hussam Al Deen Al Hussaini, H., Ebtesam Saleem Eid Alatawi, E., Jenan Ali J Shabani, J., Maryam Isa Hasan Edhrabooh, M., Shaikha Abduljalil Abdulla Alhawaj, S., Sayed Almahfoodh, M., Yaseen Alsamiri, H., Reda AlMaatoug, A., Maryam Ismail M Hayderali, M., & Ramzi Almousa, M. (2025). Management of endometriosis-related pain: comparing the effectiveness of hormonal therapy, surgical interventions, and complementary therapies.. Cureus. https://doi.org/10.7759/cureus.75590
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Nowakowska, A., Kwas, K., Fornalczyk, A., Wilczyński, J., & Szubert, M. (2022). Correlation between endometriosis and selected allergic and autoimmune diseases and eating habits.. Medicina (Kaunas, Lithuania). https://doi.org/10.3390/medicina58081038

Abulughod, N., Valakas, S., & El-Assaad, F. (2024). Dietary and nutritional interventions for the management of endometriosis.. Nutrients. https://doi.org/10.3390/nu16233988
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Habib, N., Buzzaccarini, G., Centini, G., N Moawad, G., Ceccaldi, P., Gitas, G., Alkatout, I., Gullo, G., Terzic, S., & Sleiman, Z. (2022). Impact of lifestyle and diet on endometriosis: a fresh look to a busy corner.. Przeglad Menopauzalny = Menopause Review. https://doi.org/10.5114/pm.2022.116437
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S Ghallab, R., Dina R S Gad El-Karim, D., Fayed, A., & Amr M A Rashad, A. (2023). Efficiency of conventional and nanoparticle oxytetracycline in treatment of clinical endometritis in postpartum dairy cows.. Tropical Animal Health And Production. https://doi.org/10.1007/s11250-023-03536-0

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