martes, 25 de octubre de 2016

Are there men suffering from endometriosis? (¿Pueden los hombres sufrir de endometriosis?, en una traducción libre)

Incredible as it sounds...YES.
(But if you are a man, it is very unlikely you suffer from it, it is an extreme rare condition in men).

an elderly man undergoing treatment with TACE (chlorotrianisene), an  estrogen drug used to treat prostate cancer. The patient had been taking  TACE for over 10 years for an adenocarcinoma of the prostate, when  doctors found that he also had an endometrioma (mass of endometrial  uterine tissue) of the lower abdominal wall. In the report, doctors  denied the possibility of any remnant uterine tissue, but a postmortem  exam/autopsy was never performed to confirm their theory.
(Excerpted from Endometriosis In Men? - Page 2).


https://s14-eu5.ixquick.com/cgi-bin/serveimage?url=https%3A%2F%2Fs-media-cache-ak0.pinimg.com%2Foriginals%2F6a%2Fa5%2Fb7%2F6aa5b778e9e6d3979d29fe33ed1be3d7.gif&sp=4706d328da981527fa996ce70ed06197
Source: https://es.pinterest.com/fredyeomans/endometriosis/. I would like to credit the author!. I don't quite agree with that endometriosis can't be prevented, because I think the situation is quite more complex than a simple yer or not, but in general it is a great chart.



Other than that there have only been six other cases of male endometriosis reported in locations such as the bladder, prostate and lower abdominal wall.  However, if we look at all of these cases, most of them have one thing  in common; they have been undergoing long term estrogen therapy for the  treatment of prostate cancer. This is quite important, as unusual  presentations of a disease can often give us clues as to how it arises  in women.
(Excerpted from http://www.empowher.com/endometr...).

You may think that the endo condition has only been found in elderly men undergoing hormone therapy for some reason, but there has been at least one report of endo in a young and healthy men:
One of the reports of male endometriosis was from a young man aged 27 who was otherwise  completely healthy, very different to the other reports which are mostly  much older men with prostate cancer. So not only was this an unusual  presentation of endometriosis, it was an unusual, unusual presentation,  if that makes sense. So what can this tell us about the disease as a  whole?
(Excerpted from http://endo-update.blogspot.com....).

Of course, next question is

  • What causes endometriosis in men?. Docs have advanced their hypotheses:

The authors of this report looked to the very beginning of the  development of the reproductive organs. Whilst still only a developing  embryo, there are different structures that will form the male and  female reproductive systems (there’s a nice illustration here). The female organs develop from the müllerian duct which in male embryos regresses because the embryo produces the imaginatively named müllerian inhibiting substance (MIS). The authors of this report suggest that exposure to certain  environmental toxicants (such as diethylstilbestrol or other hormone  disrupters) whilst the embryo is still developing, may lead to abnormal  production of MIS which in turn stops the müllerian duct regressing  properly, leaving small remnant patches of tissue that could, given the  right stimulus, develop into endometrial like tissue, which would appear  as endometriosis.
(Excerpted from http://endo-update.blogspot.com....).

To my understanding these arguments, while giving a (at least to an extent) convicing reason to why a man can develope endo, fail totally to explain when, where and to what extent does this condition develop.
Where can it grow is a key question. Do these cells remain undifferentiate in the tissues until some condition make them start acting as uterus shedding?. Can they migrate form one part of the body to another? (there are women suffering form endometrial cyst in the skin).
Understanding these factors could lead to significatively more effective health advices to the millions of women suffering from this condition. The lesson given we have to take from the plain fact that there are men affected by endo is that this disease needs a more indeep understanding to this serious illness that affects to an attonishing proportion of almost 10% of women.

Here there are some links to studies on endometriosis in men:
http://www.ncbi.nlm.nih.gov/pubm...
Extrapelvic endometriosis

As always I investigate some stuff about these conditions what comes to my mind is that one of the advandtages of studying them is understanding better the sequence of embroinic development. We shouldn't undervaluate what we can learn about them.
Apart from regreting that some men have to endure, of course.

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