MODERN VIEWS ON THE ROLE OF PROGESTERONE IN THE PATHOGENESIS OF GENITAL ENDOMETRIOS
This review analyzes current literature on progesterone signaling pathway dysregulation in endometriosis pathogenesis, highlighting altered progesterone sensitivity contributing to ectopic tissue growth and associated infertility.
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The paper analyzes the literature on modern views of how progesterone signaling receptor pathways contribute to the pathophysiology of genital endometriosis, motivated by the association of endometriosis with infertility and chronic pelvic pain. It concludes that altered progesterone sensitivity is a contributing factor to endometriosis development, with impaired appropriate responses of eutopic endometrium potentially linked to infertility, and changes in progesterone sensitivity of endometriotic ectopic tissue potentially supporting progression. A major caveat explicitly noted is that the mechanisms underlying progesterone receptor signaling in endometriosis are still insufficiently studied, and it highlights that changes in the expression of progesterone receptor isoforms (PGR-A/B, mPR, PGRMC) remain a debated issue due to incomplete understanding of what drives those changes. This paper is centrally about endometriosis — it reviews literature on progesterone receptor signaling and progesterone resistance in genital endometriosis pathogenesis.
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