{"paper_id":"9eeaaf29-9a94-4e9f-b3ac-f5ff60bd36d9","body_text":"Most research treats endometriosis as a single entity, potentially obscuring informative subtype-specific associations with risk factors, biomarkers and treatment responses. A 2020 study raises the hypothesis that deep endometriosis oestrogen receptor-α expression might be associated with progestin treatment and the degree of post-surgical excision pain.\nThis is a preview of subscription content, access via your institution\nAccess options\nAccess Nature and 54 other Nature Portfolio journals\nGet Nature+, our best-value online-access subscription\n27,99 € / 30 days\ncancel any time\nSubscribe to this journal\nReceive 12 print issues and online access\n176,64 € per year\nonly 14,72 € per issue\nRent or buy this article\nPrices vary by article type\nfrom$1.95\nto$39.95\nPrices may be subject to local taxes which are calculated during checkout\nReferences\nZondervan, K. T., Becker, C. M. & Missmer, S. A. Endometriosis. N. Eng. J. Med. 382, 1244–1256 (2020).\nZondervan, K. T. et al. Endometriosis. Nat. Rev. Dis. Primers 4, 9 (2018).\nPluchino, N. et al. Estrogen receptor-α immunoreactivity predicts symptom severity and pain recurrence in deep endometriosis. Fertil. Steril. 113, 1224–1231 (2020).\nBecker, C. M., Gattrell, W. T., Gude, K. & Singh, S. S. Reevaluating response and failure of medical treatment of endometriosis: a systematic review. Fertil. Steril. 108, 125–136 (2017).\nBrichant, G. et al. Heterogeneity of estrogen receptor α and progesterone receptor distribution in lesions of deep infiltrating endometriosis of untreated women or during exposure to various hormonal treatments. Gynecol. Endocrinol. 34, 651–655 (2018).\nAmerican Society for Reproductive Medicine. Revised American Society for Reproductive Medicine classification of endometriosis: 1996. Fertil. Steril. 67, 817–821 (1997).\nSchliep, K. C. et al. Pain typology and incident endometriosis. Hum. Reprod. 30, 2427–2438 (2015).\nGaudet, M. M. et al. Pooled analysis of nine cohorts reveals breast cancer risk factors by tumor molecular subtype. Cancer Res. 78, 6011–6021 (2018).\nDawood, S. et al. Defining breast cancer prognosis based on molecular phenotypes: Results from a large cohort study. Breast Cancer Res. Treat. 126, 185–192 (2011).\nZyzanski, S. J., Flocke, S. A. & Dickinson, L. M. On the nature and analysis of clustered data. Ann. Fam. Med. 2, 199–200 (2004).\nAcknowledgements\nThe authors acknowledge the support of Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) grants R01 HD094842 and R21 HD096358.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nEthics declarations\nCompeting interests\nS.M. serves as an advisory board member for AbbVie and served as a working group member for Roche. A.S. and S.M. receive funding support from the J. Willard and Alice S. Marriott and the Marriott Daughters’ Foundations – all unrelated to this work.\nRights and permissions\nAbout this article\nCite this article\nShafrir, A.L., Missmer, S.A. Towards subtypes — deep endometriosis oestrogen receptor-α expression. Nat Rev Endocrinol 16, 541–542 (2020). https://doi.org/10.1038/s41574-020-0394-0\nPublished:\nVersion of record:\nIssue date:\nDOI: https://doi.org/10.1038/s41574-020-0394-0","source_license":"public-domain-us","license_restricted":false}