What Is Retrograde Menstruation?

Retrograde menstruation is a physiological phenomenon in which part of the menstrual flow does not travel toward the vagina, as it normally does, but instead flows backward through the fallopian tubes into the peritoneal cavity.

Although this process is common, it does not always cause complications. Not all women who experience retrograde menstruation develop endometriosis, as a specific biological context is required, which may include genetic predisposition, hormonal imbalances, or a less effective immune system.

When menstrual tissue reaches the peritoneum and is not properly eliminated by the immune system, it can become inflamed, form scar tissue, and contribute to the development of endometriotic implants. In addition, factors such as chronic low-grade inflammation, digestive problems, or imbalances in the microbiota may increase this risk.

What Causes Retrograde Menstruation?

Retrograde menstruation is a physiological process that occurs in many women. It is not considered a disease and does not cause symptoms on its own.
However, the combination of retrograde menstruation with other factors, such as excess estrogen, alterations in hormone receptors, or a less efficient immune system, may contribute to the development of endometriosis.

Endometriosis

Endometriosis is an inflammatory condition with a probable genetic basis, characterized by chronic low-grade inflammation and excess estrogen.
This “silent” inflammation is often associated with intestinal alterations, although it can also affect other systems in the body. Therefore, it is essential to carry out a comprehensive assessment of the microbiota—including oral, intestinal, vaginal, and endometrial microbiota—to better understand the origin and progression of the disease and address it more effectively.

Other factors that may contribute to the development of retrograde menstruation include:

1.Hormonal imbalances
2.Genetic predisposition
3.Chronic low-grade inflammation

What Are the Symptoms of Retrograde Menstruation?

Retrograde menstruation itself does not cause symptoms. Most women experience retrograde menstruation during some menstrual cycles, and it can only be identified through medical tests, such as:

1.Ultrasound: may reveal fluid or blood remnants in the pouch of Douglas.
2.Laparoscopy: in some cases, retrograde menstruation can be directly observed in the peritoneal cavity.

The symptoms patients may experience are related to inflammation or the development of endometriosis, rather than to retrograde menstruation itself.

How Is Retrograde Menstruation Diagnosed?

Since it is a physiological phenomenon, retrograde menstruation is not routinely investigated or diagnosed. Gynecologists focus on identifying:

1.Genetic predisposition to endometriosis
2.Chronic inflammation
3.Hormonal imbalances
4.Immune system dysfunction

In this context, retrograde menstruation may become a factor that contributes to the development of endometriosis.

What Treatments Are Associated with Retrograde Menstruation?

There are no specific treatments for retrograde menstruation, as it is a natural physiological process. Blocking retrograde menstruation does not prevent endometriosis.
Currently, retrograde menstruation is considered a contributing factor, but not the only one. Other factors, such as genetic predisposition, inflammation, and hormonal imbalances, play a key role in the development of the disease.

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