Although much is known about the clinical manifestations of endometriosis, an often severe disease, its specific causes continue to elude researchers. As a consequence of this lack of full understanding, true hope for a complete cure is still far away. A very frequent disease affecting as much as 10% of reproductive-age women, endometriosis has a considerable burden on society.

In the disease, a still-unknown series of events take place, in which tissue similar to that of the inner lining of the uterus (called endometrium) begins to grow outside the uterus, namely on the ovaries, fallopian tubes, and outer surface of the uterus, rectum, bladder, or vagina. The inflammation associated with the cyclic detachment and implanting of cells to a wrong site during menstruation is responsible for its symptoms, usually infertility, pelvic pain, painful menstruation, and painful sexual intercourse.

A group of scientists from the world-renown CHU Estaing, in Clermont-Ferrand, France, propose a novel theory explaining these events. The paper entitled “Endometriosis may not be a chronic disease: an alternative theory offering more optimistic prospects for our patients,” recently published in the Fertility and Sterility journal, explores the possibility of trauma as the cause of endometriosis.

Professor Michel Canis and other physicians from the Department of Gynecologic Surgery hypothesize that disease localization and severity might be related to repeated trauma and its characteristics, facilitating the regurgitation of endometrium cells to structures outside of the uterus. They also think that, if this traumatic process is stopped and the affected tissues repaired, the disease can also be treated to a stable status without major worsening. Finally, they postulate that recurrence of the disease is not frequent unless further trauma happens, inducing the creation of new endometriotic lesions in the pelvis. Most “recurrences” can be explained by inadequate treatment and not effective worsening of the disease.

They advocate for further research on trauma as a cause for endometriosis and, if proven correct, we could be turning the page to a better and reassuring management of endometriosis, and as physicians be better able to explain the history of a disease and more effectively treat it. Ultimately, this new understanding could prove helpful in the search for a cure for endometriosis.