Endometriosis is a debilitating disease, of yet unknown etiology, globally affecting about 70 million women in child-bearing age. Previous hypotheses regarding the pathogenesis of endometriosis include retrograde menstruation grounded on peristaltic discharge of menstrual debris into the pelvic peritoneum to form endometrial tissue; the hematological and lymphatic spread theory which proposes seepage of menstrual wreckages into venous and/or lymphatic outflow leading to metastasis; the immunologic concept which assumes weakened or unresponsive immune system and presence of endometrial antibodies and the genetic hypothesis which is based on endometriosis being coded for in the genes of some females. This study takes into consideration imaginable embryonic origin of one type of endometriosis on one hand and on the other hand, viral assaults on the endometrium causing the other type of endometriosis. Therefore, this paper proposes two types of endometriosis, one arising from within the endometrium, which is labelled “endometrial endometriosis” and the other arising from outside the endometrium, hereby referred to as “endometroid endometriosis.” These two types of endometriosis may have different presentation and probably require different management.
Bamgboye M. Afolabi