If estrogen is not balanced by progesterone, it can stimulate the uterus tissue to grow abnormally, leading to fibroids and endometriosis. Clinical data show that overweight women, typically with high estrogen, tend to develop fibroids, indicating that an estrogen dominance condition can be related to fibroids.
When menstrual blood flows backward from the uterus into the fallopian tubes and spreads into pelvic tissues, part of the uterus lining can also travel with the blood and implant outside the uterus, causing endometriosis. Then why don??t all women who have menstrual back-flow develop endometriosis? The following factors may contribute to endometriosis:
1. Imbalance between estrogen and progesterone: Khaleque Newaz Khan et al. in Japan published an article about how estrogen-progesterone imbalance can be associated with endometriosis in Human Reproduction, 2005. They measured one of the growth factors called hepatocyte growth factor (HGF), a chemical stimulating tissue growth, in one type of immune cells, called macrophages, under different conditions. Women with endometriosis tend to have higher than normal levels of HGF. Furthermore, when macrophages are exposed to a higher level of estrogen without progesterone, the level of HGF increases, and its gene expression is also enhanced. When the estrogen level is dampened with another chemical or the progesterone level increased, the growth rate is much lower. Higher growth factor level may facilitate the endometrium tissue growing outside the uterus when there is back-flow of the menses.
2. Genetic make-up: Some women have higher base levels of estrogen; they tend to have a very thick endometrium build-up before their period and have a very heavy blood flow and menstrual pain. If they have poor nutrition, they could have more opportunities to develop endometriosis when menstrual blood flows backward.
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