Causes of uneven endometrium

Generally, only after a gynecological examination can you know that you have an uneven endometrium problem. This problem is caused by endometriosis. After it occurs, the patient will not obviously feel any adverse reactions in his body. He will only feel abdominal pain occasionally, but it is only a dull pain and will not affect his life. This leads to most patients waiting until the disease becomes serious before seeking treatment.

Endometriotic diseases include endometriosis and adenomyosis, both of which are caused by ectopic endometrium with growth function and often coexist clinically. However, the pathogenesis and histogenesis of the two are not exactly the same, and the clinical manifestations and their sensitivity to ovarian hormones are also different. The former is sensitive to progesterone, while the latter is not.

When endometrial tissue (glands and stroma) appears outside the uterine body, it is called endometriosis, or endometriosis for short. Ectopic endometrium can invade any part of the body, such as the navel, bladder, and kidneys. Ureters, lungs, pleura, breasts, and even arms and thighs, but most of them are located in the pelvic organs and parietal peritoneum, with the ovaries and uterosacral ligaments being the most common, followed by the uterus and other visceral peritoneum, vaginal rectal diaphragm and other parts, hence the name pelvic endometriosis.

Since endometriosis is a hormone-dependent disease, after natural menopause and artificial menopause (including drug effects, radiation exposure or surgical removal of both ovaries), the ectopic endometrial lesions can gradually shrink and absorb; pregnancy or the use of sex hormones to suppress ovarian function can temporarily stop the development of the disease. Endometriosis is morphologically benign, but has clinical behavioral characteristics similar to those of malignant tumors, such as implantation. Invasion and distant metastasis, etc. Continuous and worsening pelvic adhesions and pain. Infertility is its main clinical manifestation.

The endometrium can also spread to distant sites through the lymph and veins, resulting in ectopic implantation, which is an integral part of the endometriosis implantation theory. Many scholars have found endometrial tissue in the pelvic lymphatic vessels, lymph nodes and pelvic veins during light microscopic examination, and proposed that the endometrium can spread to distant places through the lymph and veins. Clinically, endometriosis occurring in organs far away from the pelvic cavity, such as the lungs, skin of the limbs, and muscles, may be the result of the spread of the endometrium through the blood and lymphatics. This theory cannot explain how the endometrium passes through the venous and lymphatic systems, and the incidence of endometriosis outside the pelvis is extremely low.

Coelomic metaplasia theory: The ovarian surface epithelium and pelvic peritoneum are both differentiated from the coelomic epithelium with high metaplastic potential in the embryonic period. Mayer proposed that the tissue differentiated from the coelomic epithelium can be activated and transformed into endometrial-like tissue after repeated stimulation by continuous ovarian hormones or menstrual blood and chronic inflammation. However, only animal experiments have confirmed that the mouse ovarian surface epithelium can directly metaplasia into ovarian endometriosis lesions through the K-ras activation pathway.