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Genes, Environment and Endometriosis

Reviewed 13 September 2026

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A simple explanation of why endometriosis may behave differently from one woman to another

The concept at a glance

Teaching slide titled “Environmental pollutants”, with a photograph of an industrial skyline with smoking chimneys across the top and the words “A cleaner environment for healthier women and brighter futures”. Below it, a row of five boxes: Oxidative Stress, Inflammation, Endocrine Disrupters, Clonal Selection, DNMT’s Activity. Left side: Environmental Genetics – Interaction with inherited susceptibility; Inherited Susceptible genes; an inset labelled Environmental exposure showing a globe with an arrow to a drawing of a pregnant abdomen marked F0, F1 and F2, captioned Arch Toxicol (2015) 89:677–685. Right side: Environmental Epigenetics – Environment can change how genes work without altering the DNA sequence; DNA Methylation, Histone Modification, Transcription factors; Gene Expression; microRNA Alteration; Aberrant gene Expression – May contribute to disease development and progression. Centre: a yellow oval labelled Change, Genome, Epigenome, with an arrow down to a red box labelled Disease Risk. A boxed note reads: To date, the role of environmentally-responsive TFs that are important for regulating miRNAs are least investigated. Roush and Slack, 2008; Bartel, 2009). Footer: Key References: 1. Arch Toxicol (2015) 89:677–685. 2. Roush S, Slack FJ. Trends Cell Biol. 2008;18;505–516. 3. Bartel DP. Cell. 2009;136:215–233. A yellow-bordered box reads (Political & Economic Reasons), and the slide is numbered 17.

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Evidence & references

Genes, Environment & Endometriosis
Version 1.1 · Reviewed 13 September 2026

Genetic susceptibility

Rahmioglu et al. analyzed 60,674 cases and 701,926 controls and identified 42 loci with 49 distinct association signals. These associations support polygenic susceptibility, not a deterministic test for an individual.

Epigenetics and environment

The slide combines possible mechanisms; it is not a proven chronological causal chain. Observational exposure associations and epigenetic findings do not show why a particular person developed disease. The epigenetic review is a 2025 publication, online in 2024.

Founder observation and treatment

The Founder's geographic impressions are retained as attributed personal observations, not independently measured epidemiology. Hormones can suppress activity and symptoms; they do not surgically excise lesions. Genetic or environmental findings alone do not establish the diagnosis.

Full references

  • [R36914876] Rahmioglu N, Mortlock S, Ghiasi M et al. The genetic basis of endometriosis and comorbidity with other pain and inflammatory conditions. Nat Genet. 2023;55(3):423-436. doi:10.1038/s41588-023-01323-z. PMID 36914876. Freely available
  • [S01] ESHRE. Endometriosis guideline. 2022. Freely available
  • [R32903210] Sirohi D, Al Ramadhani R, Knibbs LD. Environmental exposures to endocrine disrupting chemicals (EDCs) and their role in endometriosis: a systematic literature review. Rev Environ Health. 2021;36(1):101-115. doi:10.1515/reveh-2020-0046. PMID 32903210. Freely available
  • [R35565013] Wieczorek K, Szczęsna D, Jurewicz J. Environmental Exposure to Non-Persistent Endocrine Disrupting Chemicals and Endometriosis: A Systematic Review. Int J Environ Res Public Health. 2022;19(9):5608. doi:10.3390/ijerph19095608. PMID 35565013. Freely available
  • [R39625421] LE KN, Benor A, Decherney A. An update on epigenetic mechanisms in endometriosis. Minerva Obstet Gynecol. 2025;77(4):300-308. doi:10.23736/s2724-606x.24.05631-8. PMID 39625421. Freely available
  • [R25667014] Wei J, Li F, Yang J et al. MicroRNAs as regulators of airborne pollution-induced lung inflammation and carcinogenesis. Arch Toxicol. 2015;89(5):677-685. doi:10.1007/s00204-015-1462-4. PMID 25667014. Freely available
  • [R18774294] Roush S, Slack FJ. The let-7 family of microRNAs. Trends Cell Biol. 2008;18(10):505-516. doi:10.1016/j.tcb.2008.07.007. PMID 18774294. Freely available
  • [R19167326] Bartel DP. MicroRNAs: target recognition and regulatory functions. Cell. 2009;136(2):215-233. doi:10.1016/j.cell.2009.01.002. PMID 19167326. Freely available
  • [RTRANS] Heard E, Martienssen RA. Transgenerational epigenetic inheritance: myths and mechanisms. Cell. 2014;157(1):95-109. doi:10.1016/j.cell.2014.02.045. PMID 24679529. Freely available

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Medical information

Do not delay care; seek emergency help for a suspected emergency.

This material is for educational purposes only and does not constitute medical advice or create a clinician-patient relationship with GEM.

© 2026 Global Endometriosis Movement. All rights reserved.

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