Donate Now

What causes endometriosis?

What causes endometriosis?

The cause of endometriosis is unknown. While multiple theories exist to its etiology, these should be taken as hypotheses that need further research to be validated. This is why it is so crucial to keeping investing and funding in endometriosis research within the medical community. It is unlikely that there is only one cause for endometriosis, therefore it is useful to understand what each of these theories proposes.

Theories of Causation

  • Sampson’s Theory of Retrograde Menstruation

    Sampson’s Theory of Retrograde Menstruation

    One of the oldest theories explaining the etiology of endometriosis, proposes menstrual blood containing endometrial cells flows backward through the fallopian tubes and into the pelvic cavity rather than out of the body. These endometrial cells that should have been shed during menstruation can then lead to implantation and further spreading of endometriosis lesions.

  • Stem Cell Theory

    Genetics, stem-cell

    Some believe that the cells responsible for regeneration of the endometrial lining during one’s menstrual cycle may also play a role in the development of endometriosis. The spreading of these stem cells to ectopic regions can then lead to the differentiation of endometrial cells and cause endometriosis.

  • Genetics

    The roles genetics plays in the etiology of the disease is always a subject of debate. In the case of endometriosis, this has been studied through a micro perspective in the case of changes in gene expression to a more macro level in terms of what it means to have a family history of endometriosis.

  • Mulleriosis & Embryonic Origin Theory

    Abnormal development of the uterus is one of the primary causes of endometriosis according to the theory of Mulleriosis, particularly in the Mullerian duct system. This has often been a popular field of study amongst fertility specialists and the endometriosis community.

  • Other proposed theories

    Other proposed endometriosis theories

    There are a number of other theories that have been put forth examining the possible cause of endometriosis. These theories range from involving whole organ systems, such as the lymphatic and immune system, to more molecular nuanced details, such as the role hormones and oxidative stress play in promoting endometriosis.


  1. Figueira, P. G. M., Abrão, M. S., Krikun, G., & Taylor, H. (2011). STEM CELLS IN ENDOMETRIUM AND THEIR ROLE IN THE PATHOGENESIS OF ENDOMETRIOSIS. Annals of the New York Academy of Sciences, 1221(1), 10–17. http://doi.org/10.1111/j.1749-6632.2011.05969.x

  2. Chan Y, Jayaprakasan K, Zamora J, Thornton J, Raine-Fenning N, Coomarasamy A. “The Prevalence of Congenital Uterine Anomalies in Unselected and High-Risk Populations: A Systematic Review.” Hum Reprod Update. 2011;17(6):761-771

  3. Woelfer B, Salim R, Banerjee S, Elson J, Regan L, Jurkovic D. “Reproductive Outcomes in Women with Congenital Uterine Anomalies Detected by Three-Dimensional Ultrasound Screening.” Obstet Gynecol. 2001;98(6): 1099-1103.

  4. Reichman, David; Laufer, Marc R.; Robinson, Barrett K. (2009). "Pregnancy outcomes in unicornuate uteri: A review". Fertility and Sterility. 91 (5): 1886–94. doi:10.1016/j.fertnstert.2008.02.163PMID 18439594.

  5. Leyendecker G, Kunz G, Wildt L, Beil D, Deininger H. “Uterine Hyperperistalsis and Dysperistalsis as Dysfunctions of the Mechanism of Rapid Sperm Transport in Women with Endometriosis and Infertility.” Human Reprod. 1996;11(7):1542-1551.

  6. LaMonica R, Pinto J, Luciano D, Lyapis A, Luciano A. “Incidence of Septate Uterus in Reproductive-Aged Women with and Without Endometriosis.” J Minim Invasive Gynecol. 2016;23(4):610-613.

  7. Pocobelli, G., Doherty, J. A., Voigt, L. F., Beresford, S. A., Hill, D. A., Chen, C., … Weiss, N. S. (2011). Pregnancy history and risk of endometrial cancer. Epidemiology (Cambridge, Mass.), 22(5), 638–645. http://doi.org/10.1097/EDE.0b013e3182263018