Pathogenesis and pathophysiology of endometriosis

Abstract

Originally described over three hundred years ago, endometriosis is classically defined by the presence of endometrial glands and stroma in extrauterine locations. Endometriosis is an inflammatory, estrogen-dependent condition associated with pelvic pain and infertility. This work reviews the disease process from theories regarding origin to the molecular basis for disease sequelae. A thorough understanding of the histopathogenesis and pathophysiology of endometriosis is essential to the development of novel diagnostic and treatment approaches for this debilitating condition.

Copyright © 2012 American Society for Reproductive Medicine. All rights reserved.

Figures

Figure 1

Theories regarding endometriosis pathogenesis. E2=estradiol

Figure 2

Red vesicular lesions with focal hemorrhage observed on the posterior aspect of the broad ligament. Note prominent focal vascularity in immediate vicinity of lesions.

Figure 3

Local estradiol production in endometriotic lesions and eutopic endometrium, inflammation, and pain. 17βHSD = 17β hydroxysteroid dehydrogenase; E1=estrone; E2=estradiol; PGE2=prostaglandin E2; PGF2α=prostaglandin F2α; NGF= nerve growth factor.

Figure 4

Phenotypic subtypes of peritoneal endometriosis. A. Red vesicular lesion B. Powder burn lesion C. Fibrotic lesion D. Allen-Masters peritoneal defect.