Endometriosis and the Immune System – the Missing Link

Endometriosis is a chronic condition that affects millions of women worldwide, and unfortunately is often misdyagnosed or its symptoms are dismissed. Despite its prevalence, there remains a significant gap in deeply understanding its causes and possible solutions beside strong painkillers and/or surgery.

The Causes of Endometriosis

Endometriosis is characterized by the presence of endometrial-like tissue outside the uterus, most commonly found on the ovaries, fallopian tubes, and tissues lining the pelvis. While the exact cause of endometriosis remains elusive, several factors have been identified as potential contributors and triggers to its development:

  1. Retrograde Menstruation: During menstruation, some menstrual blood containing endometrial cells flows backward through the fallopian tubes into the pelvic cavity. While this phenomenon occurs in many individuals, the immune system typically clears these cells. In individuals with endometriosis, immune dysregulation may prevent the efficient clearance of these cells, leading to their implantation and growth in other pelvic locations.
  2. Endometrial-like Tissue Before Birth: Some researchers suggest that endometriosis may originate from embryonic cells that develop into endometrial-like tissue even before birth.
  3. Transformation from Stem Cells: Stem cells, which have the capacity to differentiate into various cell types, may give rise to endometrial-like tissue outside the uterus, contributing to the development of endometriosis.
  4. Low Androgen Exposure in Utero: Environmental toxins may disrupt hormonal balance during fetal development, leading to reduced exposure to androgens, which play a role in regulating the growth of endometrial tissue. This imbalance may predispose individuals to endometriosis later in life.
  5. Transgenerational Toxic Exposure: Exposure to environmental toxins such as dioxins, either in the womb or across generations, may induce epigenetic changes that increase the risk of endometriosis.
  6. Mold Disease and Estrogen: Environmental factors such as mold exposure may exacerbate estrogen dominance, which is known to stimulate the growth of endometrial lesions. This underscores the importance of addressing environmental triggers in managing endometriosis.

The Role of Estrogen and the Immune System

Estrogen plays a significant role in the development and progression of endometriosis, as it stimulates the growth of endometrial lesions. But estrogen dominance is not the only factor involved in the progression of edometriosis as also the immune system plays a big part a critical role in the pathogenesis of endometriosis. Macrophages and natural killer (NK) cells are key players in the immune response against endometrial cells outside the uterus.

The immune dysfunction observed in endometriosis shares similarities with autoimmune diseases, characterized by reduced NK cell activity and dysregulated macrophage function. Furthermore, there appears to be a correlation between endometriosis and autoimmune diseases such as lupus, inflammatory bowel disease (IBD), celiac disease, and rheumatoid arthritis (RA).


In conclusion, endometriosis is a multifactorial condition with complex etiology involving genetic predisposition, environmental factors, hormonal imbalances, and immune dysfunction. Working one to one with an healthcare professional will provide a deeper understanding of the intricate interplay between these factors, which is crucial for developing effective strategies for the prevention and management of endometriosis, ultimately improving the quality of life for individuals affected by this debilitating condition.