Endometriosis may not be a chronic disease: an alternative theory offering more optimistic prospects for our patients

For more than a century, endometriosis has been described as unexplained, poorly understood, or enigmatic. As a result treatments are not based on the pathophysiology of the disease, which consequently cannot be cured effectively, meaning that the symptoms, which have major consequences on women's quality of life, will almost inevitably recur.

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Authors

Michel Canis, M.D., Ph.D., Nicolas Bourdel, M.D., Céline Houlle, M.D., Anne Sophie Gremeau, M.D., Revaz Botchorishvili, M.D., Sachiko Matsuzaki, M.D.

Volume 105, Issue 1, Pages 32-34

Abstract

For more than a century, endometriosis has been described as unexplained, poorly understood, or enigmatic. As a result treatments are not based on the pathophysiology of the disease, which consequently cannot be cured effectively, meaning

that the symptoms, which have major consequences on women's quality of life, will almost inevitably recur. Such pessimistic perspectives have devastating consequences, particularly on the results of treatments for chronic pelvic

pain. All the mechanisms proposed, whether retrograde menstruation, metaplasia, lymphatic and vascular metastasis, embryology, stem cells, and mullerianosis, may occur in all € women. However, we still do not know why and when the disease

begins, and why some patients have minimal disease, whereas others have extensive peritoneal implants and adhesions or large, deep infiltrating nodules or ovarian cysts. We also are almost at a loss to describe a usual and somewhat

‘‘logical’’ spontaneous evolution of this disease, except for ovarian endometriomas, which may increase in diameter and rupture. The ‘‘activity’’ and/or the ‘‘aggressiveness’’ of the disease proposed for many years to explain these differences

in phenotypes still has to be elucidated. Most of the fears of physicians and patients are based on a few ideas. First the risk of recurrence is supposed to be very high, whereas many recurrent clinical symptoms may be explained by inadequate

response to medical treatments and/or incomplete surgical excision of the disease.

Read the full text at: http://www.fertstert.org/article/S0015-0282(15)01926-3/fulltext


Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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