The origin of endometriosis

Key phenomena and definitions

Patient articles & presentations

Introducing endometriosis
A summary of the key facts about the disease endometriosis: What it is and what it is not, what it looks like, who can develop it, where it develops, what the symptoms are, and how common it is.

Delineating the disease: Obtaining accurate information
How can we obtain accurate data about endometriosis? What is needed in order to increase our understanding of this disease and to avoid making the same old mistakes?

Scientific articles & presentations

Redefining endometriosis in the modern era
An overview of the origin, history, diagnosis, and treatment of endometriosis.

Is endometriosis an autotransplant?
Sampson's theory of reflux menstruation suggests that endometriosis is one form of a condition known as an autotransplant. This study seeks to characterize autotransplants as they are described in the literature and to determine whether endometriosis resembles an autotransplant.

The visual appearance of endometriosis and its impact on our concepts of the disease
The visual appearance of endometriosis is important because every intellectual and therapeutic process begins with a surgeon identifying disease. Inaccurate identification of disease can introduce selection bias at a first-order level and confound all conclusions, leading to inaccurate concepts of epidemiology, natural history, disease origin and treatment.

Age related evolution in color appearance of endometriosis
Endometriosis is diagnosed microscopically by a pathologist who studies tissue harvested from the pelvis by a surgeon. The surgeon's eye is the only determinant of what is excised, so identification of all disease is important. There is a growing, but not yet widespread, appreciation that endometriosis has many appearances. Since descriptive morphology of endometriosis historically has been in terms of color (i.e., the "black powder-burn" lesion), this study seeks to categorize qualitatively and to estimate the prevalence of the various colors of appearance of biopsy-proven endometriosis.

The distribution of endometriosis in the pelvis by age groups and fertility
Some clinicians believe that endometriosis involves progressively more widespread areas of the pelvis as patients get older and that pregnancy confers relative protection against spread of the disease throughout the pelvis. To examine these beliefs, this study evaluates both the frequency distribution of disease by age groups as well as the number of pelvic areas involved compared with age groups and fertility status in patients with endometriosis.

Theories of origin

Patient articles & presentations

Who was Sampson and what is Sampson's theory?
A short introduction to Sampson and his theory of retrograde menstruation.

The problems with Sampson's theory - is it a theory or an excuse?
Sampson's theory of the origin of endometriosis remains popular despite its inability to accommodate the key phenomena of this disease. Here we examine what Sampson's theory is and why it fails so catastrophically.

If Sampson's theory doesn't work, then what causes endometriosis?
In the above articles and slide-shows we have provided a volume of amunition undermining Sampson's theory, the most popular theory of origin of endometriosis. If Sampson's theory fails then what is the explanation for the origin of this disease, and what would it need to encapsulate in order to succeed in explaining all the phenomena surrounding endometriosis?

The immune system and endometriosis
Immunological dysfunction is often cited as a core factor in the development and maintenance of endometriosis. We will take a closer look at the relationship between endometriosis and the immune system and examine whether immune dysfunction is indeed a feasible causal factor in this disease, and what bearing this has on clinical practice.

Scientific articles & presentations

A critical review of the development of Sampson's theory of origin of endometriosis
Could Sampson have been wrong? A critical appraisal of the development of his theory of origin of endometriosis to illuminate errors of thought which persist to this day, allowing us to discard what is wrong so that we may see what is correct.

Was Sampson wrong?
An examination of the flaws of Sampson's theory and why attempts at accommodating for these flaws in 'hybrid' theories also fail to adequately explain the phenomena and origin of endometriosis.

Asteroid mapping, HOX genes and endometriosis
In this presentation given at the 2nd Annual Scientific and Surgical Symposium of the Endometriosis Foundation of America in 2011, Dr. Redwine explains why Sampson's theory of origin of endometriosis is fatally flawed and presents his alternative best-fit model of the pathogenesis of endometriosis, Mülleriosis. He explains the role of HOX genes in the laying down of endometriotic tissue during embryogenesis.

Mülleriosis: The best-fit theory of the origin of endometriosis
What is mulleriosis and why is it the best-fit theory of the origin of endometriosis?