Endometriosis is defined as heterotopic islands of uterine mucosa (endometrium) found in many locations.
Pelvic sites include: peritoneal surfaces (bladder, cul-de-sac, pelvic side walls, broad ligaments, uterosacral ligaments, fallopian tubes, and uterus), lymph nodes, ovaries, bowel.
Distant sites include: vagina, cervix, abdominal wall, arm, leg, pleura, lung, diaphragm, kidneys, spleen, gallbladder, nasal mucous membranes, spinal canal, stomach, breast
Causes of endometriosis include: Retrograde menstruation (Sampson's theory); Lymphatic/vascular metastases (Halban's theory); Direct implantation; Coelomic metaplasia (coelomic epithelium undergoes metaplasia forming functioning endometrium)
Risk factors for endometriosis include: Hereditary/genetic predisposition; Personality traits (achieving, egocentric, overanxious, perfectionist, intelligent, underweight - but validity of these observations lacking); Delayed childbearing; Luteinized unruptured follicle syndrome (granulosa/theca cells undergo luteinization but actual follicular rupture fails to occur, thereby predisposing to limited progesterone secretion into peritoneal cavity thus allowing refluxed endometrial cells to implant and proliferate).
Iron overload is an important aspect.
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