{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T01:47:05Z","timestamp":1790128025261,"version":"4.0.1"},"reference-count":103,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,2,9]],"date-time":"2023-02-09T00:00:00Z","timestamp":1675900800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82071623"],"award-info":[{"award-number":["82071623"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["2017ZZ01016"],"award-info":[{"award-number":["2017ZZ01016"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["SHDC2020CR2062B"],"award-info":[{"award-number":["SHDC2020CR2062B"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003399","name":"Science and Technology Commission of Shanghai Municipality","doi-asserted-by":"publisher","award":["82071623"],"award-info":[{"award-number":["82071623"]}],"id":[{"id":"10.13039\/501100003399","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003399","name":"Science and Technology Commission of Shanghai Municipality","doi-asserted-by":"publisher","award":["2017ZZ01016"],"award-info":[{"award-number":["2017ZZ01016"]}],"id":[{"id":"10.13039\/501100003399","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003399","name":"Science and Technology Commission of Shanghai Municipality","doi-asserted-by":"publisher","award":["SHDC2020CR2062B"],"award-info":[{"award-number":["SHDC2020CR2062B"]}],"id":[{"id":"10.13039\/501100003399","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Shanghai Shenkang Center for Hospital Development","award":["82071623"],"award-info":[{"award-number":["82071623"]}]},{"name":"Shanghai Shenkang Center for Hospital Development","award":["2017ZZ01016"],"award-info":[{"award-number":["2017ZZ01016"]}]},{"name":"Shanghai Shenkang Center for Hospital Development","award":["SHDC2020CR2062B"],"award-info":[{"award-number":["SHDC2020CR2062B"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biomolecules"],"abstract":"<jats:p>Practically unknown outside of China, the \u201cendometrial determinism\u201d theory was proposed to account for the apparent gap between the relatively low prevalence of endometriosis and nearly universal retrograde menstruation. Attracting uncritical advocacy, the theory culminates in a recent consensus by elite Chinese gynecologists in favor of \u201croot treatment\u201d, intended to nip endometriosis in the bud. Correcting endometrial \u201cdefects\u201d can gain further momentum by the presence of cancer-driver mutations such as KRAS mutations in the endometrium of women with endometriosis and the recent introduction of therapeutics aiming to rectify the effect of these mutations for cancer treatment. We provide a critical appraisal of evidence for endometrial aberrations in endometriosis and relevant experimental evidence. All available evidence of endometrial \u201cdefect\u201d is invariably post hoc and may well be secondary to induced endometriosis. We propose that the theory of \u201cendometrial determinism\u201d needs to demonstrate a clear causal and a phylogenetic relationship between endometrial aberrations and endometriosis. We argue that while it is highly likely that endometriosis is a consequence of retrograde menstruation, the case that molecular aberrations as a sole or a necessary determinant remains to be proven. \u201cRoot treatment\u201d is a worthy ambition but as of now it is close to a fanciful Utopia.<\/jats:p>","DOI":"10.3390\/biom13020336","type":"journal-article","created":{"date-parts":[[2023,2,10]],"date-time":"2023-02-10T02:33:27Z","timestamp":1675996407000},"page":"336","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["From Retrograde Menstruation to Endometrial Determinism and a Brave New World of \u201cRoot Treatment\u201d of Endometriosis: Destiny or a Fanciful Utopia?"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8511-7624","authenticated-orcid":false,"given":"Sun-Wei","family":"Guo","sequence":"first","affiliation":[{"name":"Research Institute, Shanghai Obstetrics & Gynecology Hospital, Fudan University, Shanghai 200011, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5404-252X","authenticated-orcid":false,"given":"Marwan","family":"Habiba","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of Leicester, Leicester LE1 7HA, Leicestershire, UK"},{"name":"Women and Perinatal Services, Leicester Royal Infirmary, Leicester LE1 5WW, Leicestershire, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3168-4594","authenticated-orcid":false,"given":"Giuseppe","family":"Benagiano","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Dentistry, Sapienza, University of Rome, 00185 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1016\/S0002-9378(15)30003-X","article-title":"Peritoneal endometriosis due to the menstrual dissemination of endometrial tissue into the peritoneal cavity","volume":"14","author":"Sampson","year":"1927","journal-title":"Am.J. 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