Hormonal regulation of endometriosis and the rationales and effects of gonadotrophin-releasing hormone agonist treatment: a review
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This review discusses estrogen's role in endometriosis, analyzes hormonal metabolism and receptor expression, and examines the effects of gonadotropin-releasing hormone agonist treatment, noting variable responses and potential for prolonged, less hypoestrogenic treatment.
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Abstract
The knowledge about the role of oestrogen in the regulation of endometriosis growth and symptoms has been reviewed. Studies on oestrogen and progesterone metabolism and receptivity in endometriotic tissue and the impact on growth regulation and clinical symptoms of steroidal hormones are discussed. These include tissue sample assays, ex-vivo tissue culturing as well as clinical studies concerning the effect of different hormonal treatment. All studies published on steroid receptors in endometriotic tissue have shown lower levels of oestrogen and progesterone receptors in endometriotic tissue than in uterine endometrium. These data might, at least partly, explain the poor clinical response to hormonal treatment experienced in some cases. However, in cases of hormone-sensitive endometriotic tissue, a complete ovarian inactivation is not important, as comparable reducing effects on lesions and symptoms are seen after various hormonal treatments leading to a varying degree of ovarian inactivation. A less pronounced hypo-oestrogenism during treatment gives less severe consequences for the future, mainly concerning the bone mass and the circulation, and might allow a prolonged symptom-free period on low-dose treatment when needed. Not all cases of endometriosis are receptive to hormonal treatment.
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Cited by (30)
- Regulated Cell Death in Endometriosis 2024
- Possible Role of the Posterior Compartment Peritonectomy, as a Part of the Complex Surgery, Regarding Recurrence Rate, Improvement of Symptoms and Fertility Rate in Patients with Endometriosis, Long-Term Follow-Up 2019
- Effects of progressive muscular relaxation training on anxiety, depression and quality of life of endometriosis patients under gonadotrophin-releasing hormone agonist therapy 2012
- Functional analyses of endometriosis-related polymorphisms in the estrogen synthesis and metabolism-related genes 2012
- Lymphatic spread of endometriosis to pelvic sentinel lymph nodes: a prospective clinical study 2011
- History of Endometriosis: A 20th‐Century Disease 2011
- Endometriosis, a modern syndrome 2011
- Traitements des localisations urologiques de l'endométriose 2009
- Is aromatase expression in the endometrium the cause of endometriosis and related infertility? 2009
- Ten estrogen-related polymorphisms and endometriosis: a study of multiple gene-gene interactions 2005
- Polimorfismo do gene do receptor de progesterona (PROGINS) em mulheres com endometriose pélvica 2004
- Gonadotropin-releasing hormone agonist induces apoptosis and reduces cell proliferation in eutopic endometrial cultures from women with endometriosis 2003
- Will GnRH antagonists assist in the treatment of benign gynaecological diseases? 2002
- Recurrence of endometriosis in women with bilateral adnexectomy (with or without total hysterectomy) who received hormone replacement therapy 2002
- Medikamentöse Therapie der Endometriose mit GnRH-Antagonisten 2002
- Use of GnRH antagonists in the treatment of endometriosis 2002
- Use of GnRH antagonists in the treatment of 2002
- PROGINS receptor gene polymorphism is associated with endometriosis 2002
- Changes in quality of life after hormonal treatment of endometriosis 2001
- Current and potential application of GnRH agonists in gynecologic practice 2000
- Extrapelvic Endometriosis: A Case Report and Review of the Literature 2000
- Reduced proliferation and cell adhesion in endometriosis 2000
- Postoperative administration of monophasic combined oral contraceptives after laparoscopic treatment of ovarian endometriomas: a prospective, randomized trial 2000
- Medical Treatment of Endometriosis-Associated Pain 1999
- Current drug therapy recommendations for the treatment of endometriosis 1999
- Fibrinolytic factors in endometriotic tissue, endometrium, peritoneal fluid, and plasma from women with endometriosis and in endometrium and peritoneal fluid from healthy women 1998
- Quantitative enzyme immunoassay and semiquantitative immunohistochemistry of oestrogen and progesterone receptors in endometriotic tissue and endometrium 1997
- Stereometric evaluation of peritoneal endometriosis and endometriotic nodules of the rectovaginal septum 1996
- Theories on the pathogenesis of endometriosis 1996
- Theories on the pathogenesis of endometriosis 1996
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