What Causes Endometriosis? A 2026 Medical Guide from Dr. Priyadatt Patel

“How did I get this?” This is the most emotional and frequent question patients ask during consultations at Balaji Horizon Women’s Hospital. Understanding what causes endometriosis is the fundamental key to selecting the right treatment pathway—whether that involves high-precision surgery or a personalized fertility roadmap.

In 2026, medical science has moved beyond simple answers. We now recognize endometriosis as a multisystem inflammatory disorder. At our Science City clinic in Ahmedabad, Dr. Priyadatt Patel and Dr. Shreya Iyengar Patel integrate the latest global research to provide a clear, evidence-based diagnosis for our patients.

1. Understanding What Causes Endometriosis: Retrograde Flow

The most established answer to “what causes endometriosis” remains Retrograde Menstruation (Sampson’s Theory). This occurs when menstrual blood flows backward through the fallopian tubes into the pelvic cavity instead of leaving the body.

While 90% of women experience some degree of retrograde flow, only 10% develop the disease. This suggests that retrograde flow is merely the “vehicle.” The true cause lies in why these cells are allowed to survive, attach, and grow in the pelvic environment. At Balaji Horizon, we look beyond the flow to the underlying pelvic health.

However, 2026 research from institutions like Yale Medicine suggests a deeper layer: Stem Cells. In some patients, bone marrow-derived stem cells are drawn to the pelvis to “repair” inflammation, but instead, they transform into endometrial-like lesions, fueling the disease’s growth.

2. Genetic Factors in What Causes Endometriosis

If a close relative has the condition, your risk increases up to tenfold. Genetics account for roughly 50% of the risk factor. We now know that endometriosis is polygenic, meaning multiple genes contribute to its development.

Recent 2026 genomic studies have identified markers that control how your body processes estrogen and manages inflammation. At Balaji Horizon, we review your family history to determine if early intervention, such as 3D Advanced Laparoscopy and Hysteroscopy, is necessary to protect your ovarian reserve and ensure future IVF success.

3. The Immune System & “Immune Skip”

In a healthy body, the immune system acts as a surveillance team, identifying and destroying cells that are growing where they don’t belong. However, in endometriosis, the immune system is “tricked.”

The disease creates a microenvironment where immune cells (macrophages) fail to recognize the lesions as foreign. This “immune skip” allows the tissue to develop its own blood supply (angiogenesis) and nerve endings. This is what causes endometriosis to become a chronic pain condition rather than a temporary irritation. Our treatment protocols in Ahmedabad focus on reducing this systemic inflammation to prevent recurrence.

4. Coelomic Metaplasia: The Transformation Theory

Coelomic Metaplasia explains why endometriosis can occur in rare sites like the lungs, diaphragm, or even in patients who have never menstruated. This theory suggests that normal cells lining the abdomen (peritoneal cells) can actually transform into endometrial-like tissue.

This transformation is often triggered by:

• Estrogen Dominance: Endometriosis is an estrogen-dependent disease; high levels act like fuel.

• Environmental Triggers: Exposure to endocrine disruptors in our modern environment can spark these cellular changes.

5. New Research: Stem Cells and What Causes Endometriosis to Spread

A groundbreaking area of research in 2026 focuses on Stem Cells. Evidence suggests that bone marrow-derived stem cells can travel through the bloodstream and settle in the pelvis. Once there, they differentiate into endometrial tissue. This explains why the disease is systemic and why “burning” the surface of a lesion (ablation) is often unsuccessful. To truly treat the cause, one must perform deep excision to remove the entire root of the stem-cell-driven growth.

6. Hormonal Imbalance and Estrogen’s Role

While hormones may not be the “initial” cause, they are the primary “promoters.” Estrogen causes endometrial tissue—both inside and outside the uterus—to thicken and bleed. Because the blood from lesions outside the uterus has no way to exit the body, it causes internal scarring and “adhesions.”

At Balaji Horizon, managing this hormonal environment is critical for patients undergoing Advanced IVF and Fertility Care. We don’t just look at the surgery; we look at the hormonal balance that sustains the disease.

7. How Identifying the Cause of Endometriosis Changes Treatment

At Balaji Horizon, we don’t just treat symptoms; we address the drivers. By identifying whether your case is driven by hormonal imbalance, genetics, or immune dysfunction, we can better predict the success of various fertility treatments.

We strictly follow the latest World Endometriosis Society global standards and use Endometriosis Fertility Index (EFI) research to provide a data-driven path to motherhood for our Ahmedabad patients.

Conclusion: Expert Care at Balaji Horizon Women’s Hospital

Understanding what causes endometriosis allows us to provide a curative approach rather than a temporary fix. Through Dr. Priyadatt Patel’s expertise in 3D excision surgery, we aim to remove the disease from its root, giving you back your quality of life.

Dr. Priyadatt Patel and Dr. Shreya Iyengar Patel provide a multidisciplinary approach in Science City, Ahmedabad, combining advanced surgery with compassionate Pregnancy and Fertility care.

📍 Visit Us: Satyamev Eminence, Beside Saptak Bungalows, Science City Road, Ahmedabad 380060.

🌐 Website: www.balajihorizon.com

📞 Consultation: +91 9909496027

Schedule a consultation at our Science City clinic.

About the Author: Dr. Priyadatt Patel is a renowned specialist in 3D Advanced Laparoscopy and Endometriosis at Balaji Horizon Women’s Hospital, Ahmedabad. He is committed to providing international surgical standards for women’s health.