Why Does Endometriosis Come Back After Surgery? The Gut, Estrobolome, and Bioenergetic Mechanism — thesis

Endometriosis recurs because excision removes lesions but not the substrate that selected for them. A mechanistic reading of the gut estrobolome, beta-glucuronidase-driven estrogen recirculation, LPS-driven inflammation, pelvic mast cell infiltration, mitochondrial dysfunction, and iron-driven oxidative damage — and why surgery and hormonal suppression contain the disease but rarely resolve it.