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There are a number of theories as to how these cells come to be in the wrong
place, but in reality, no one knows for sure.
We know that during a normal
period some of the blood flows backwards through the fallopian tubes and ends up
in the pelvis. Usually this fluid and any of the cells it contains are absorbed.
In some women the cells stick to the pelvic lining, and produce a substance
which stimulates the lining of the pelvis to grow blood vessels to supply them
with nutrients. Hence, instead of being absorbed, the cells survive and grow.
This is the most logical theory, but we also know that endometriosis can develop
in women with blocked tubes, and is occasionally seen in those who are born
without a uterus. In this situation it is thought that the lining layer
(peritoneum) of the pelvis changes spontaneously into endometriosis cells.
Endometriosis cells, like normally situated endometrial cells are sensitive
to hormonal changes. This means that when the lining of the uterus sheds and a
period occurs, endometriosis cells also bleed and change. The result of this is
that bleeding and irritation occurs in the pelvic lining or wherever the
endometriosis cells are.
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