Hormone treatment of endometriosis: The estrogenthreshold hypothesis

Barbieri RL, R L Barbieri, Robert L. Barbieri
American journal of obstetrics and gynecology · 1992 · vol. 166(2) , pp. 740–745 · doi:10.1016/0002-9378(92)91706-g · PMID:1536260 · W1990060114
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This paper investigates the estrogen threshold hypothesis as it relates to hormone treatment for endometriosis.

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Abstract

In women with recurrent pelvic pain caused by endometriosis, hormonal therapy with a gonadotropin-releasing hormone agonist is an effective alternative to surgical therapy. The basis for medical treatment of endometriosis is that endometriosis lesions are dependent on estradiol for continued growth. Further, end organ tissue varies in its sensitivity to estradiol. This forms the basis of the estrogen threshold hypothesis, that is, that a concentration of estradiol that will partially prevent bone loss may not stimulate endometrial growth. Thus there is a hierarchy of organ response to estradiol such that calcium metabolism is most sensitive followed by gonadotropin secretion, vaginal epithelial growth, lipid metabolism, and liver protein production. Similarly, breast cancer is most sensitive and endometriosis is least sensitive to estrogen. These differences may allow the design of regimens with a gonadotropin-releasing hormone agonist that maintain a therapeutic response and ameliorate potential adverse effects.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Estradiol Gonadotropin-Releasing Hormone Bone and Bones Bone and Bones Bone Density Calcium Calcium Clinical Protocols Drug Therapy, Combination Endometriosis Endometriosis Endometriosis Estradiol Estradiol Estradiol Female Gonadotropin-Releasing Hormone Humans Ovariectomy

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (27)

Cited by (50)

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License: CC0 · commercial use OK