It is estimated that 5% - 10% of women may suffer from this disease. The data shows that there is a growing trend. At the meeting held by the National Academy of child health and human development in 1995, it was recognized that the incidence of this disease is 10%, of which 30% - 40% have painful symptoms.
There are more Asians than Europeans. According to the medical report in 1992, Asian women account for 51% of patients, while only 22% of European women. 30% - 40% of infertile women suffer from endometriosis. Endometriosis is not a newly discovered disease, which has been reported in ancient Egyptian and Chinese literature.
The cause of endometriosis has not been clear. It is generally believed that it is caused by ectopic implantation of the endometrium, and it is also believed that it is caused by the differentiation of coelomic epithelium, heredity, abnormal immune regulation, inflammation, and other factors.
1. Implantation theory
During menstruation, the blood is discharged from the uterus and vagina, but a small part of the blood mixed with the falling endometrial fragments flows into the abdominal cavity from the fallopian tube because of some reasons and is planted on the surface of the pelvic organs to form the endometriosis focus.
Clinically, endometriosis occurs in organs far away from the pelvis, such as lungs, limbs, skin, and muscles, which may be the result of the spread of endometrium through blood circulation and lymph.
2. Genetic and physical factors
Clinical observation found that endometriosis has a certain degree of familial aggregation, and the incidence of some patients may be related to heredity, and physical factors such as obesity, overweight, over height also have a certain relationship. The incidence of patients whose mothers and sisters suffered from endometriosis are seven times more at risk than those without a family history.
3. Immune and inflammatory factors
Abnormal immune regulation plays an important role in the occurrence and development of endometriosis. As a foreign body, the endometrium that flows to the abdominal cavity with menstrual blood will activate the immune system in the body and mobilize a large number of immune cells and body fluids to eliminate. If the immune function in the body is defective, it will develop into endometriosis.
Endometriosis is related to some inflammation, such as peritonitis, which is manifested by the increase of macrophages, inflammatory cytokines, growth factors, and angiogenic substances in the peritoneal fluid, thus promoting the survival and proliferation of ectopic endometrium and leading to local fibroproliferation and adhesion.
4. Iatrogenic endometrial transplantation
This is a kind of artificial transplantation of endometrium to some parts, which is often seen in cesarean section, curettage in early and middle pregnancy, perineum side cutting in delivery, induced abortion, and other processes.
5. Endocrine dysfunction
No matter the source of ectopic endometrium, its growth changes are related to the ovarian endocrine. Estrogen can promote growth and progesterone can inhibit it. It is found that most patients are lack of progesterone, which promotes the occurrence and development of the disease.
6. Other factors
Environmental factors may also increase the incidence rate of endometriosis. It is found that dioxin can increase the risk of endometriosis in women. Angiogenic factors may also lead to the occurrence of endometriosis, the increase of vascular growth factors in the peritoneal fluid may lead to an increase of pelvic microvascular growth and lead to endometriosis. In addition, the decrease of apoptosis of ectopic endometrial cells may be related to the process of disease.
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