Endometriosis - a Western disease ?

Dr John Sampson first proposed that retrograde menstruation gave rise to endometriosis in the 1920's. Contemporary gynaecology does not give a mechanism for this "reverse" flow of menstrual debris from the uterus along the Fallopian tubes. New studies (UK, Australia, Belgium) confirm abnormal nerves in the uterus that may upset the normal pattern of menstruation. Others have shown disordered motility of the Fallopian tubes though without demonstrating abnormal nerves in the Fallopian tubes.


Image provided by Dr Gregory Brodsky.

The image, produced by Dr Gregory Brodsky, shows a cross section of the Fallopian tube as it passes through the uterine muscle (intramural Fallopian tube). Nerve fibres stain brown using an antibody named anti-S100 (standard histological technique). At 2, 6, 8 and 10 o'clock there are collections of abnormal nerves around the Fallopian tube. Nerves are important in propelling material in the correct direction. These abnormal nerves will also promote retrograde menstruation and prevent normal progress of the egg from the ovary to the uterus. Injuries in childbirth and during physical efforts during defecation may contribute to these observations - among other events.