INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCHERS
ISSN: 3030-332X Impact factor: 8,293
Volume 11, issue 2, May 2025
https://wordlyknowledge.uz/index.php/IJSR
worldly knowledge
Index:
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735
PREVALENCE AND ETIOLOGICAL FACTORS OF ENDOMETRIOSIS: A
LITERATURE REVIEW
Abdullayeva Sitorabonu Abdullayevna
Zarmed University
Abstract.
Endometriosis is a chronic gynecological condition characterized by the presence of
endometrial-like tissue outside the uterine cavity, leading to pain, infertility, and diminished
quality of life. Globally, it affects approximately 10% of women of reproductive age, equating
to over 190 million individuals. Despite its prevalence, the etiology remains multifactorial and
not fully understood. This literature review synthesizes current knowledge on the global
prevalence and potential etiological factors of endometriosis, including genetic predisposition,
hormonal imbalances, immune system dysfunction, environmental exposures, and anatomical
anomalies. Understanding these factors is crucial for early diagnosis, effective management,
and the development of targeted therapies.
Keywords:
Endometriosis, Prevalence, Etiology, Genetics, Hormonal Imbalance, Immune
Dysfunction, Environmental Factors
Introduction.
Endometriosis is a debilitating condition wherein endometrial-like tissue
proliferates outside the uterine cavity, commonly affecting the ovaries, fallopian tubes, and
peritoneum. Clinically, it manifests through chronic pelvic pain, dysmenorrhea, dyspareunia,
and infertility. The global burden is substantial, with estimates indicating that approximately
10% of women of reproductive age are affected, translating to over 190 million individuals
worldwide. The condition not only impairs physical health but also exerts psychological and
socio-economic impacts.
Despite its high prevalence, the pathogenesis of endometriosis remains elusive, attributed to a
complex interplay of genetic, hormonal, immunological, and environmental factors. Diagnostic
delays are common, averaging 6.7 to 11.6 years globally, due to symptom variability and lack
of non-invasive diagnostic tools. This review aims to consolidate current epidemiological data
and explore the multifactorial etiological theories underpinning endometriosis.
Methods.
A comprehensive literature search was conducted across databases including
PubMed, Scopus, and Web of Science, focusing on publications from 2015 to 2025. Keywords
used were "endometriosis prevalence," "endometriosis etiology," "genetic factors," "hormonal
imbalance," "immune dysfunction," and "environmental exposure."
Inclusion criteria
encompassed peer-reviewed articles, systematic reviews, and meta-analyses that provided data
on the prevalence and etiological factors of endometriosis. Exclusion criteria included case
reports, editorials, and studies lacking robust methodological frameworks. Data extraction
focused on prevalence rates, diagnostic delays, and proposed etiological mechanisms.
Results
Prevalence
. Endometriosis affects approximately 10% of women of reproductive age globally,
equating to over 190 million individuals. Prevalence rates vary by region, with higher rates
reported in Oceania (67.94 per 100,000) and Central Asia (60.87 per 100,000), and lower rates
in North America (31.23 per 100,000) and East Asia (36.41 per 100,000). Among women with
infertility, the prevalence of endometriosis ranges from 30% to 50%.
INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCHERS
ISSN: 3030-332X Impact factor: 8,293
Volume 11, issue 2, May 2025
https://wordlyknowledge.uz/index.php/IJSR
worldly knowledge
Index:
google scholar, research gate, research bib, zenodo, open aire.
https://scholar.google.com/scholar?hl=ru&as_sdt=0%2C5&q=wosjournals.com&btnG
https://www.researchgate.net/profile/Worldly-Knowledge
https://journalseeker.researchbib.com/view/issn/3030-332X
736
Diagnostic Delays. The average time from symptom onset to diagnosis ranges from 6.7 years in
countries like the UK and Spain to 11.6 years in the United Arab Emirates . Factors
contributing to delays include normalization of symptoms, lack of awareness, and limited
access to specialized care.
Etiological Factors.
Genetic Predisposition. Family history is a significant risk factor, with
first-degree relatives of affected individuals having a six-fold increased risk. Genome-wide
association studies have identified multiple loci associated with endometriosis, including
WNT4, GREB1, and IL1A, implicating genes involved in reproductive tissue development and
immune response.
Hormonal Imbalance.
Estrogen dependency is a hallmark of endometriosis. Elevated estrogen
levels and increased sensitivity of estrogen receptors in ectopic endometrial tissue promote
proliferation and inflammation . Progesterone resistance further exacerbates the condition by
impairing the anti-proliferative effects of progesterone on endometrial tissue.
Immune System Dysfunction.
Altered immune responses contribute to the survival of ectopic
endometrial tissue. Studies have shown elevated levels of macrophages, natural killer cells, and
pro-inflammatory cytokines in the peritoneal fluid of affected individuals, facilitating
implantation and growth of endometrial lesions .
Environmental Exposures.
Exposure to endocrine-disrupting chemicals (EDCs) such as
dioxins, bisphenol A (BPA), and phthalates has been implicated in endometriosis development.
These compounds can alter hormonal signaling and immune responses, promoting ectopic
endometrial tissue growth .
Anatomical Factors.
Retrograde menstruation, where menstrual blood flows backward through
the fallopian tubes into the pelvic cavity, is a widely accepted theory. However, since this
occurs in up to 90% of women, additional factors like immune dysfunction and genetic
predisposition are necessary to explain why only some develop endometriosis .
Discussion.
The multifactorial etiology of endometriosis underscores the complexity of its
pathogenesis. Genetic studies highlight the role of hereditary factors, while hormonal and
immune system dysregulations provide insight into the mechanisms facilitating ectopic tissue
survival. Environmental exposures to EDCs further complicate the landscape, suggesting that
both intrinsic and extrinsic factors contribute to disease development.
Diagnostic delays remain a significant challenge, often leading to disease progression and
reduced quality of life. The lack of non-invasive diagnostic tools necessitates reliance on
laparoscopic surgery, which is not always accessible. Public health initiatives aimed at
increasing awareness and improving access to care are essential.
Current treatments focus on symptom management through hormonal therapies and surgical
interventions. Emerging therapies targeting specific molecular pathways offer hope for more
effective and personalized treatments. However, further research is needed to fully elucidate
the pathophysiological mechanisms and develop targeted therapies.
INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCHERS
ISSN: 3030-332X Impact factor: 8,293
Volume 11, issue 2, May 2025
https://wordlyknowledge.uz/index.php/IJSR
worldly knowledge
Index:
google scholar, research gate, research bib, zenodo, open aire.
https://scholar.google.com/scholar?hl=ru&as_sdt=0%2C5&q=wosjournals.com&btnG
https://www.researchgate.net/profile/Worldly-Knowledge
https://journalseeker.researchbib.com/view/issn/3030-332X
737
Conclusion.
Endometriosis is a prevalent and complex condition with a multifactorial etiology
involving genetic, hormonal, immunological, and environmental factors. Despite its significant
impact on women's health, diagnostic delays and limited treatment options persist.
Advancements in understanding the underlying mechanisms are crucial for developing effective
diagnostics and targeted therapies. Multidisciplinary approaches combining clinical care,
research, and public health initiatives are essential to address the challenges posed by
endometriosis.
References:
1. Endometriosis UK. Endometriosis Facts and Figures. https://www.endometriosis-
uk.org/endometriosis-facts-and-figures
2. ZipDo. Endometriosis Industry Statistics. https://zipdo.co/endometriosis-industry-statistics/
3. Wikipedia. Endometriosis. https://en.wikipedia.org/wiki/Endometriosis
4. Dovepress. Current Knowledge on Endometriosis Etiology: A Systematic Review of
Literature.
https://www.dovepress.com/current-knowledge-on-endometriosis-etiology-a-
systematic-review-of-lit-peer-reviewed-fulltext-article-IJWH
5. IMR Press. Global Burden of Endometriosis in 204 Countries and Territories from 1990 to
2019. https://www.imrpress.com/journal/CEOG/49/10/10.31083/j.ceog4910235/htm
6.
PubMed.
Aetiology
and
pathogenesis
of
endometriosis
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a
review.
https://pubmed.ncbi.nlm.nih.gov/23416836/
