Endometriosis: where are we and where are we going?

Alexis Greene; Alexis D Greene; Stephanie Tanadini‐Lang; Stephanie A Lang; Jessica A Kendziorski; Julie M Sroga-Rios; J. Sroga-Rios; Thomas J Herzog; Katherine A Burns

doi:10.1530/rep-16-0052

Endometriosis: where are we and where are we going?

Alexis Greene, Alexis D Greene, Stephanie Tanadini‐Lang, Stephanie A Lang, Jessica A Kendziorski, Julie M Sroga-Rios, J. Sroga-Rios, Thomas J Herzog, Katherine A Burns

Reproduction (Cambridge, England) · 2016 · vol. 152(3) , pp. R63–R78 · doi:10.1530/rep-16-0052 · PMID:27165051 · W2371764543

review OA: bronze CC0 ⤵ 143 in-corpus citations

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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This review discusses recent advancements in understanding endometriosis's hormonal, immune, and treatment aspects, highlighting current knowledge gaps and urgent research needs.

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Abstract

Endometriosis currently affects ~5.5 million reproductive-aged women in the U.S. with symptoms such as painful periods (dysmenorrhea), chronic pelvic pain, pain with intercourse (dyspareunia), and infertility. It is defined as the presence of endometrial tissue outside the uterine cavity and is found predominately attached to sites within the peritoneal cavity. Diagnosis for endometriosis is solely made through surgery as no consistent biomarkers for disease diagnosis exist. There is no cure for endometriosis and treatments only target symptoms and not the underlying mechanism(s) of disease. The nature of individual predisposing factors or inherent defects in the endometrium, immune system, and/or peritoneal cavity of women with endometriosis remains unclear. The literature over the last 5 years (2010-2015) has advanced our critical knowledge related to hormones, hormone receptors, immune dysregulation, hormonal treatments, and the transformation of endometriosis to ovarian cancer. In this review, we cover the aforementioned topics with the goal of providing the reader an overview and related references for further study to highlight the progress made in endometriosis research, while concluding with critical areas of endometriosis research that are urgently needed.

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Condition tags

mesh:D004715endometriosischronic_pelvic_paindysmenorrheadyspareuniainfertility

MeSH descriptors

Endometriosis Endometriosis Endometriosis Female Humans

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References (100)

Cited by (50)

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[1] 17β-Estradiol and Lipopolysaccharide Additively Promote Pelvic Inflammation and Growth of Endometriosis via openalex

[2] Ablation of Leptin Signaling Disrupts the Establishment, Development, and Maintenance of Endometriosis-Like Lesions in a Murine Model via openalex

[3] Abundance and Localization of Progesterone Receptor Isoforms in Endometrium in Women With and Without Endometriosis and in Peritoneal and Ovarian Endometriotic Implants via openalex

[4] A GFP endometriosis model reveals important morphological characteristics of the angiogenic process that govern benign and malignant diseases. via openalex

[5] Analysis of cytokines in the peritoneal fluid of endometriosis patients as a function of the menstrual cycle stage using the Bio-Plex® platform via openalex

[6] A new isoform of steroid receptor coactivator-1 is crucial for pathogenic progression of endometriosis via openalex

[7] Angiostatic agents prevent the development of endometriosis-like lesions in the chicken chorioallantoic membrane via openalex

[8] A Novel Mouse Model of Endometriosis Mimics Human Phenotype and Reveals Insights into the Inflammatory Contribution of Shed Endometrium via openalex

[9] An Overview of Treatments for Endometriosis via openalex

[10] A tumor necrosis factor-α inhibitor reduces the embryotoxic effects of endometriotic peritoneal fluid via openalex

[11] Basal and Steroid Hormone-Regulated Expression of CXCR4 in Human Endometrium and Endometriosis via openalex

[12] Bentamapimod (JNK Inhibitor AS602801) Induces Regression of Endometriotic Lesions in Animal Models via openalex

[13] Biomarkers of endometriosis via openalex

[14] Blocking of Stromal Cell-Derived Factor-1 Reduces Neoangiogenesis in Human Endometriosis Lesions in a Mouse Model via openalex

[15] Cancer risk after a hospital discharge diagnosis of endometriosis via openalex

[16] Chinese herbal medicine for endometriosis via openalex

[17] Chinese medicinal plants for advanced endometriosis after conservative surgery: a prospective, multi-center and controlled trial. via openalex

[18] Clinicopathological characteristics of ovarian carcinomas associated with endometriosis via openalex

[19] Combination of non-invasive and semi-invasive tests for diagnosis of minimal to mild endometriosis via openalex

[20] Comparison of clinical outcomes of patients with clear cell and endometrioid ovarian cancer associated with endometriosis to papillary serous carcinoma of the ovary via openalex

[21] Continuous Versus Cyclic Oral Contraceptives After Laparoscopic Excision of Ovarian Endometriomas via openalex

[22] Continuous versus cyclic oral contraceptives after laparoscopic excision of ovarian endometriomas: a systematic review and metaanalysis via openalex

[23] Continuous versus cyclic oral contraceptives for the treatment of endometriosis: a systematic review via openalex

[24] Correlation of angiogenic cytokines-leptin and IL-8 in stage, type and presentation of endometriosis via openalex

[25] Development and prevention of postsurgical adhesions in a chimeric mouse model of experimental endometriosis via openalex

[26] Development of endometriosis-like lesions after transplantation of human endometrial fragments onto the chick embryo chorioallantoic membrane via openalex

[27] Dienogest for the treatment of deep endometriosis: Case report and literature review via openalex

[28] Dienogest in the treatment of endometriosis via openalex

[29] Distinct peritoneal fluid ghrelin and leptin in infertile women with endometriosis and their correlation with interleukin-6 and vascular endothelial growth factor via openalex

[30] Distinct β-Catenin and PIK3CA Mutation Profiles in Endometriosis-Associated Ovarian Endometrioid and Clear Cell Carcinomas via openalex

[31] Dual suppression of estrogenic and inflammatory activities for targeting of endometriosis via openalex

[32] Effect of antiangiogenic treatment on peritoneal endometriosis-associated nerve fibers via openalex

[33] Effect of Letrozole on endometriosis-related pelvic pain. via openalex

[34] Effect of Vascular Endothelial Growth Factor Inhibition on Endometrial Implant Development in a Murine Model of Endometriosis via openalex

[35] Effects of 17β‐estradiol on the release of monocyte chemotactic protein‐1 and MAPK activity in monocytes stimulated with peritoneal fluid from endometriosis patients via openalex

[36] Elagolix, an Oral GnRH Antagonist, Versus Subcutaneous Depot Medroxyprogesterone Acetate for the Treatment of Endometriosis: Effects on Bone Mineral Density via openalex

[37] Elagolix, a Novel, Orally Bioavailable GnRH Antagonist under Investigation for the Treatment of Endometriosis-Related Pain via openalex

[38] Elevated immunoreactivity of RANTES and CCR1 correlate with the severity of stages and dysmenorrhea in women with deep infiltrating endometriosis via openalex

[39] Endometrial ability to implant in ectopic sites can be prevented by interleukin-12 in a murine model of endometriosis via openalex

[40] Endometrial carcinoma of the ovary arising in endometrial tissue in that organ via openalex

[41] ENDOMETRIAL CARCINOMA OF THE OVARY, ARISING IN ENDOMETRIAL TISSUE IN THAT ORGAN via openalex

[42] Endometrioid ovarian cancer and endometriotic cells exhibit the same alteration in the expression of interleukin-1 receptor II: To a link between endometriosis and endometrioid ovarian cancer via openalex

[43] Endometriosis via openalex

[44] Endometriosis via openalex

[45] Endometriosis: alternative methods of medical treatment via openalex

[46] Endometriosis and ovarian cancer: Thoughts on shared pathophysiology via openalex

[47] Endometriosis and physical exercises: a systematic review via openalex

[48] Endometriosis, dysmenorrhoea and diet via openalex

[49] Endometriosis research: animal models for the study of a complex disease via openalex

[50] Epithelial Ovarian Cancers and Endometriosis via openalex

[51] ERβ- and Prostaglandin E2-Regulated Pathways Integrate Cell Proliferation via Ras-like and Estrogen-Regulated Growth Inhibitor in Endometriosis via openalex

[52] Estrogen Receptor β Modulates Apoptosis Complexes and the Inflammasome to Drive the Pathogenesis of Endometriosis via openalex

[53] Eutopic and ectopic stromal cells from patients with endometriosis exhibit differential invasive, adhesive, and proliferative behavior via openalex

[54] Evaluation of selected angiogenic and inflammatory markers in endometriosis before and after danazol treatment via openalex

[55] Evidence of a genetic link between endometriosis and ovarian cancer via openalex

[56] Experimental endometriosis via openalex

[57] Expression of human β-defensin-2 in the eutopic and ectopic endometrial tissues in patients with endometriosis via openalex

[58] Expression of interleukin-1 (IL-1) ligands system in the most common endometriosis-associated ovarian cancer subtypes via openalex

[59] Expression of macrophage migration inhibitory factor in human endometriosis: Relation to disease stage, menstrual cycle and infertility via openalex

[60] Expression of Natural Cytotoxicity Receptors on Peritoneal Fluid Natural Killer Cell and Cytokine Production by Peritoneal Fluid Natural Killer Cell in Women with Endometriosis via openalex

[61] Frequency of ovarian endometriosis in epithelial ovarian cancer patients. via openalex

[62] Further Studies on Experimental Endometriosis via openalex

[63] Gene Expression Analysis of Endometrium Reveals Progesterone Resistance and Candidate Susceptibility Genes in Women with Endometriosis via openalex

[64] Genome-Wide DNA Methylation Analysis Predicts an Epigenetic Switch for GATA Factor Expression in Endometriosis via openalex

[65] Gonadotrophin‐releasing hormone analogue or dienogest plus estradiol valerate to prevent pain recurrence after laparoscopic surgery for endometriosis: a multi‐center randomized trial via openalex

[66] Higher expression of vascular endothelial growth factor (VEGF) and its receptor VEGFR-2 (Flk-1) and metalloproteinase-9 (MMP-9) in a rat model of peritoneal endometriosis is similar to cancer diseases via openalex

[67] Human endometriotic xenografts in immunodeficient RAG-2/γ(c)KO mice via openalex

[68] Hyperestrogenism: A Relevant Risk Factor for the Development of Cancer from Endometriosis via openalex

[69] <i>ARID1A</i> Mutations in Endometriosis-Associated Ovarian Carcinomas via openalex

[70] IL-17A concentration of seminal plasma and follicular fluid in infertile men and women with various clinical diagnoses via openalex

[71] IL-17A Contributes to the Pathogenesis of Endometriosis by Triggering Proinflammatory Cytokines and Angiogenic Growth Factors via openalex

[72] IL-22 in the endometriotic milieu promotes the proliferation of endometrial stromal cells via stimulating the secretion of CCL2 and IL-8. via openalex

[73] Imbalance in Cytokines from Interleukin‐1 Family – Role in Pathogenesis of Endometriosis via openalex

[74] Immunohistochemical study of the ubiquitin–nuclear factor-?B pathway in the endometrium of the baboon (Papio anubis) with and without endometriosis via openalex

[75] Increased asymmetric dimethylarginine and enhanced inflammation are associated with impaired vascular reactivity in women with endometriosis via openalex

[76] Increased Expression of Pattern Recognition Receptors and Nitric Oxide Synthase in Patients with Endometriosis via openalex

[77] Increased levels of human neutrophil peptides 1, 2, and 3 in peritoneal fluid of patients with endometriosis: association with neutrophils, T cells and IL-8 via openalex

[78] Individual patient data meta-analysis of randomized evidence to assess the effectiveness of laparoscopic uterosacral nerve ablation in chronic pelvic pain via openalex

[79] Induction of endometriosis in mice: A new model sensitive to estrogen via openalex

[80] Inflammatory Status Influences Aromatase and Steroid Receptor Expression in Endometriosis via openalex

[81] Inhibiting MMP activity prevents the development of endometriosis in the chicken chorioallantoic membrane model via openalex

[82] Inhibition of steroid sulfatase decreases endometriosis in an in vivo murine model via openalex

[83] Interleukin-6 and other soluble factors in peritoneal fluid and endometriomas and their relation to pain and aromatase expression via openalex

[84] Intrapelvic injection of menstrual endometrium causes endometriosis in baboons (Papio cynocephalus and Papio anubis) via openalex

[85] Is acupuncture in addition to conventional medicine effective as pain treatment for endometriosis? via openalex

[86] Laparoscopic surgery for endometriosis via openalex

[87] Laparoscopic surgery for endometriosis via openalex

[88] Laparoscopic surgery for subfertility associated with endometriosis via openalex

[89] Leptin, its receptor and aromatase expression in deep infiltrating endometriosis via openalex

[90] Levonorgestrel-releasing intrauterine device used for dysmenorrhea: five-year literature review via openalex

[91] Lipoxin A4 regulates expression of the estrogen receptor and inhibits 17β-estradiol induced p38 mitogen-activated protein kinase phosphorylation in human endometriotic stromal cells via openalex

[92] Loss of ARID1A/BAF250a-expression in endometriosis: a biomarker for risk of carcinogenic transformation? via openalex

[93] Loss of ARID1A Expression Is an Early Molecular Event in Tumor Progression From Ovarian Endometriotic Cyst to Clear Cell and Endometrioid Carcinoma via openalex

[94] Low-dose oral contraceptive pill for dysmenorrhea associated with endometriosis: a placebo-controlled, double-blind, randomized trial via openalex

[95] Macrophage Migration Inhibitory Factor Is Involved in a Positive Feedback Loop Increasing Aromatase Expression in Endometriosis via openalex

[96] Malignant changes in endometriosis. via openalex

[97] Medical Treatments for Endometriosis-Associated Pelvic Pain via openalex

[98] Metastatic or Embolic Endometriosis, due to the Menstrual Dissemination of Endometrial Tissue into the Venous Circulation. via openalex

[99] MicroRNA expression profile in endometriosis: its relation to angiogenesis and fibrinolytic factors via openalex

[100] Models of endometriosis and their utility in studying progression to ovarian clear cell carcinoma via openalex