What is the role of retrograde menstruation in the etiology of endometriosis?

Updated: May 10, 2021
  • Author: G Willy Davila, MD; Chief Editor: Michel E Rivlin, MD  more...
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Early in the 20th century (1927), Samson proposed his theory of retrograde menstruation through the fallopian tubes into the peritoneal cavity as a cause of endometriosis. Subsequent studies have shown that retrograde menstruation is a quite common physiologic event and cannot adequately explain the extrauterine implantation of endometrial tissue. Diagnostic laparoscopy during the perimenstrual period has shown that as many as 90% of women with patent fallopian tubes have bloody peritoneal fluid. Nonetheless, conditions that increase the rate of retrograde menstruation, such as congenital outflow tract obstructions, do increase the risk of endometriosis. Various animal experiments and clinical observations support this theory. [11, 12, 13, 14]

Because most women do not have endometriosis, perhaps immunologic or hormonal dysfunction leaves some women predisposed.

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