From Retrograde Menstruation to Endometrial Determinism and a Brave New World of “Root Treatment” of Endometriosis: Destiny or a Fanciful Utopia?
Practically unknown outside of China, the “endometrial determinism” theory was proposed to account for the apparent gap between the relatively low prevalence of endometriosis and nearly universal retrograde menstruation. Attracting uncritical advocacy, the theory culminates in a recent consensus by...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-02-01
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| Series: | Biomolecules |
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| Online Access: | https://www.mdpi.com/2218-273X/13/2/336 |
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| author | Sun-Wei Guo Marwan Habiba Giuseppe Benagiano |
| author_facet | Sun-Wei Guo Marwan Habiba Giuseppe Benagiano |
| author_sort | Sun-Wei Guo |
| collection | DOAJ |
| description | Practically unknown outside of China, the “endometrial determinism” theory was proposed to account for the apparent gap between the relatively low prevalence of endometriosis and nearly universal retrograde menstruation. Attracting uncritical advocacy, the theory culminates in a recent consensus by elite Chinese gynecologists in favor of “root treatment”, intended to nip endometriosis in the bud. Correcting endometrial “defects” can gain further momentum by the presence of cancer-driver mutations such as KRAS mutations in the endometrium of women with endometriosis and the recent introduction of therapeutics aiming to rectify the effect of these mutations for cancer treatment. We provide a critical appraisal of evidence for endometrial aberrations in endometriosis and relevant experimental evidence. All available evidence of endometrial “defect” is invariably post hoc and may well be secondary to induced endometriosis. We propose that the theory of “endometrial determinism” needs to demonstrate a clear causal and a phylogenetic relationship between endometrial aberrations and endometriosis. We argue that while it is highly likely that endometriosis is a consequence of retrograde menstruation, the case that molecular aberrations as a sole or a necessary determinant remains to be proven. “Root treatment” is a worthy ambition but as of now it is close to a fanciful Utopia. |
| first_indexed | 2024-03-11T09:05:43Z |
| format | Article |
| id | doaj.art-219d12e888234a4287475f5d644220da |
| institution | Directory Open Access Journal |
| issn | 2218-273X |
| language | English |
| last_indexed | 2024-03-11T09:05:43Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomolecules |
| spelling | doaj.art-219d12e888234a4287475f5d644220da2023-11-16T19:23:45ZengMDPI AGBiomolecules2218-273X2023-02-0113233610.3390/biom13020336From Retrograde Menstruation to Endometrial Determinism and a Brave New World of “Root Treatment” of Endometriosis: Destiny or a Fanciful Utopia?Sun-Wei Guo0Marwan Habiba1Giuseppe Benagiano2Research Institute, Shanghai Obstetrics & Gynecology Hospital, Fudan University, Shanghai 200011, ChinaDepartment of Health Sciences, University of Leicester, Leicester LE1 7HA, Leicestershire, UKFaculty of Medicine and Dentistry, Sapienza, University of Rome, 00185 Roma, ItalyPractically unknown outside of China, the “endometrial determinism” theory was proposed to account for the apparent gap between the relatively low prevalence of endometriosis and nearly universal retrograde menstruation. Attracting uncritical advocacy, the theory culminates in a recent consensus by elite Chinese gynecologists in favor of “root treatment”, intended to nip endometriosis in the bud. Correcting endometrial “defects” can gain further momentum by the presence of cancer-driver mutations such as KRAS mutations in the endometrium of women with endometriosis and the recent introduction of therapeutics aiming to rectify the effect of these mutations for cancer treatment. We provide a critical appraisal of evidence for endometrial aberrations in endometriosis and relevant experimental evidence. All available evidence of endometrial “defect” is invariably post hoc and may well be secondary to induced endometriosis. We propose that the theory of “endometrial determinism” needs to demonstrate a clear causal and a phylogenetic relationship between endometrial aberrations and endometriosis. We argue that while it is highly likely that endometriosis is a consequence of retrograde menstruation, the case that molecular aberrations as a sole or a necessary determinant remains to be proven. “Root treatment” is a worthy ambition but as of now it is close to a fanciful Utopia.https://www.mdpi.com/2218-273X/13/2/336aberrationcausalendometriosisendometrial determinismphylogeneticretrograde menstruation |
| spellingShingle | Sun-Wei Guo Marwan Habiba Giuseppe Benagiano From Retrograde Menstruation to Endometrial Determinism and a Brave New World of “Root Treatment” of Endometriosis: Destiny or a Fanciful Utopia? Biomolecules aberration causal endometriosis endometrial determinism phylogenetic retrograde menstruation |
| title | From Retrograde Menstruation to Endometrial Determinism and a Brave New World of “Root Treatment” of Endometriosis: Destiny or a Fanciful Utopia? |
| title_full | From Retrograde Menstruation to Endometrial Determinism and a Brave New World of “Root Treatment” of Endometriosis: Destiny or a Fanciful Utopia? |
| title_fullStr | From Retrograde Menstruation to Endometrial Determinism and a Brave New World of “Root Treatment” of Endometriosis: Destiny or a Fanciful Utopia? |
| title_full_unstemmed | From Retrograde Menstruation to Endometrial Determinism and a Brave New World of “Root Treatment” of Endometriosis: Destiny or a Fanciful Utopia? |
| title_short | From Retrograde Menstruation to Endometrial Determinism and a Brave New World of “Root Treatment” of Endometriosis: Destiny or a Fanciful Utopia? |
| title_sort | from retrograde menstruation to endometrial determinism and a brave new world of root treatment of endometriosis destiny or a fanciful utopia |
| topic | aberration causal endometriosis endometrial determinism phylogenetic retrograde menstruation |
| url | https://www.mdpi.com/2218-273X/13/2/336 |
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