Looking at endometriosis–diagnosis and disease mechanisms through a mechanical lens

Endometriosis is a chronic gynecological disorder marked by the growth of endometrial-like tissue outside the uterus, often resulting in pain and infertility and affecting overall quality of life. Despite its prevalence, diagnostic delays persist due to reliance on invasive laparoscopy and the lack of sensitive, specific, non-invasive biomarkers. Current molecular and imaging tools have improved detection but remain limited, underscoring the need for new diagnostic strategies. This review introduces a mechanobiological perspective, exploring how cellular biophysical properties such as cell stiffness, deformability, and contractility can potentially serve as functional biomarkers for endometriosis. We examine lesion subtypes, menstrual cycle dynamics, and key biological processes such as decidualization, epithelial-mesenchymal transition (EMT), and stromal remodeling through a mechanical lens. Parallels are drawn between endometriosis and cancer to underscore the diagnostic potential of tissue and cell mechanics. We specifically highlight menstrual effluent as a promising non-invasive, cell-rich sample uniquely suited for mechanical profiling. Together, these insights suggest that viewing endometriosis with a mechanical lens may accelerate diagnostic innovation and uncover new mechanisms driving disease development and progression.