David Redwine
He was the physician and researcher in endometriosis who unraveled endometriosis back in the 1980s — Bend, Oregon, United States — August 2023 — All rights reserved - Original article WHR, vol. (1) p. 1. (Portuguese version)
The origin of endometriosis is a crucial topic, as the rational treatment of the disease depends on knowledge of its cause. Medical literature continues to describe endometriosis as a "confusing, mysterious, and enigmatic disease" affecting approximately 10% of women worldwide. Such uncertainty, even after more than a century of studies, clearly indicates that the basic assumptions about the disease are incorrect. And what could be more fundamental than the origin of the disease? The confusion surrounding endometriosis inevitably points to a failure to understand its origin. As Sampson's theory of retrograde menstruation is the most frequently cited cause, the trail of confusion leads directly to this theory, which becomes the main factor of disorientation.
Sampson's theory proposes that, during menstruation, some menstrual fluid escapes through the ends of the fallopian tubes, carrying blood, endometrial cells, and tissue fragments into the peritoneal cavity, where they implant and develop, giving rise to endometriosis. Considering that about 10% of women of childbearing age have endometriosis, this process would occur literally billions of times each year. Menstrual fluid is composed of erythrocytes, stromal cells, and glandular cells (Figure 1). The dimensions of these cells vary between 8 micrometers (erythrocytes) and up to 75 micrometers (glandular cells). Fragments of refluxed tissue could theoretically measure between 20 and 900 micrometers—dimensions visible to the naked eye. If Sampson's theory were correct, extensive photomicrographic evidence of the adhesion, proliferation, and invasion steps of refluxed tissue would be expected. However, the absence of these fundamental images, even after 150 years of research, represents the fatal flaw of the theory: if the phenomenon actually occurred, it would be impossible not to record it . The only "evidence" available are illustrative diagrams (Figure 3). While virologists capture images of viruses and astronomers photograph supernovas, does science still lack basic images of refluxed tissue? This is unacceptable. The theory of retrograde menstruation as the origin of endometriosis must be rejected.