How Does Endometriosis Develop: Retrograde Menstruation Theory

Medsblog. About Health and Medicine

May 8, 2009

Sampson’s theory of retrograde menstruation is by far the most popular theory of the development of endometriosis and it probably explains the vast majority of cases. According to this theory endometriosis develops when menstrual fluid from the uterus flows backwards through the fallopian tubes and out into die pelvic cavity during the menstrual period. This process of backward flow is known as retrograde menstruation which is a normal process that occurs in the majority of women. When the menstrual fluid flows out of the ends of the fallopian tubes it is deposited onto the surrounding organs and tissues. The menstrual fluid contains blood and fragments of endometrium. Some of these fragments of endometrium are still living and they implant themselves on the surface of the tissue and begin to grow and function. These patches of implanted endometrium are known as endometrial implants, deposits or cysts. Although it is known that most women have retrograde menstruation, it is not known why only a small percentage actually develop endometriosis.

Comment from Leslie

Retrograde Menstruation – Interesting concept. Feminists have called endometriosis – an uptight uterus. Same difference.  When a woman does not allow her body to slow down so that the uterine lining can be released the discharge will flow back into the pelvic cavity and not through the cervix.

Learning how to live with your hormone cycle is crucial.  Charting your cycle is a great tool – listing your physical, mental and emotional symptoms.  Your can learn more about this on Female Mystique – or in my book – “Understanding Your Mood, Mind and Hormone Cycle.”


Author: Leslie Carol Botha

Author, publisher, radio talk show host and internationally recognized expert on women's hormone cycles. Social/political activist on Gardasil the HPV vaccine for adolescent girls. Co-author of "Understanding Your Mood, Mind and Hormone Cycle." Honorary advisory board member for the Foundation for the Study of Cycles and member of the Society for Menstrual Cycle Research.


  1. I would tend to agree that there does seem to be a missing puzzle piece when it comes to Sampson’s Retrograde Menstruation theory of endometriosis development. However, in your comment below the theory you state “when a woman does not allow her body to slow down…”. I interpret this as saying that our lifestyle and profession contribute to retrograde menstruation from month to month and the possibility of developing endometriosis. If this is indeed what is meant by the comment, it is entirely misleading and an inaccurate description to provide to other readers.

    There used to be a theory that “career women” were the only ones to develop this disease. These women were thought of as women who put on hold their natural childbearing capacities in order to further their career. This theory has since been proven to be wrong; endometriosis effects people from all socio-economic groups. I personally find this theory to be offensive towards women, blaming them for a biological problem that is out of their control.

    Melissa R.

  2. Melissa – thank you so much for your comment to this blog. Yes, Endometriosis does affect women from all socio-economic groups – and it is a serious and painful issue for those afflicted with this condition.

    However, our hormonal and reproductive health is a biological process that is within our control. The myth and social construct – that “menstruation is a disease” – has led us to believe that this natural and time-honored cycle IS out of our control. This myth has led to a myriad of problems for women, their children and their partners. And allowed for the pharmaceutical industry to reap profits off our bodies.

    I just found this blog that I will be posting next to my site:

    2nd Chakra Series – 21 Ways to Care for Your Sacral Chakra -

    “10) Recognize the life phase you are in, and contemplate how you can work with it. As women, the phases of our lives are driven by our reproductive phases in a way that men‚Äôs are not. Each of these phases draw on and challenge our 2nd chakra energies in different ways. I talked about this a bit in Women‚Äôs Energy Bodies ‚Äì Cycles and Phases, and a book mentioned in the comments on that post, Joan Borysenko‚Äôs A Woman‚Äôs Book of Life, has a lot of interesting material along these lines.

    11) If you are a mother, routinely assess your energetic balance. Recognize the phase of mother/child relationship you are in, and think about pacing, balance, and energy access issues as discussed in the Motherhood and Creativity post. Allow yourself solitude.

    12) Learn to recognize, accept and work with your personal cycles of going inward and outward. A lot has been written about women‚Äôs menstrual cycles, and how that impacts our energy field and awareness. The general theme is that during the first half of our cycle, from the end of menstruation to ovulation, we are more externally focused, yang-driven, and intent and creation oriented. Then during the second half, from ovulation to the start menstruation, we are more internally focused, yin-driven, and intuition and incubation oriented (and more absorbent.)”

    Medical science is slowly but finally catching up to Natural Science that adheres to the cyclical nature of all of life – from the cells in our bodies to the planetary rhythms of the universe. This is the new model for “health.” Living out of balance with the cycles of the universe and our bodies is the recipe for “disease.”

  3. “A woman’s body is the battlefield where she fights for liberation. It is through her body that oppression works, reifying her, sexualizing her, victimizing her, disabling her.”

    Germaine Greer: The Whole Woman

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