Progesterone Resistance in Endometriosis

Jeevitha Poorasamy, Jayasree Sengupta, Asmita Patil, Debabrata Ghosh
In: EMJ Reproductive Health · 2022 · doi:10.33590/emjreprohealth/22-00109 · W4292980179
article OA: diamond CC0 ⤵ 5 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This review discusses progesterone resistance in endometriosis, focusing on dysregulated progesterone receptor expression and action in eutopic and ectopic tissues and unmet questions regarding progesterone treatment failure.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 ⓘ

This paper is an overview of progesterone resistance in endometriosis, focusing on how suppressed progesterone receptor (PGR) expression and progesterone action are linked to endometriosis-associated chronic pelvic pain, infertility, inflammatory disorders, and cancer, and considering whether PGR polymorphisms relate to susceptibility. It describes dysregulated PGR expression and activity in both eutopic and ectopic endometrial tissues versus control endometrium, noting that the epigenetic mechanisms suppressing PGR differ between eutopic and ectopic tissue, and that progestin failure in a subset of patients supports impaired progesterone machinery. A key caveat is that it is a narrative review aimed at synthesizing evidence rather than presenting new experimental data, and it highlights “unmet questions” about why progesterone treatment fails clinically. This paper is centrally about endometriosis — it reviews the concept and mechanisms of progesterone resistance, including PGR suppression, in endometriosis.

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Abstract

Endometriosis is characterised by the presence of endometrium-like tissue on the pelvis and other organs. Progesterone resistance due to suppressed progesterone receptor (PGR) expression and action is a general feature of endometriosis and is a cause of endometriosis-associated chronic pelvic pain, infertility, inflammatory disorders, and cancer. It appears that progesterone receptor polymorphisms may not be associated with the susceptibility to endometriosis. On the other hand, PGR expression and activity in target cells is significantly dysregulated in both eutopic and ectopic tissues compared with control endometrium. However, the underlying epigenetic mechanisms for PGR suppression in the eutopic tissue are different from ectopic tissue. The aim of this paper was to present an overview of different aspects of progesterone resistance and its application in endometriosis. Finally, this article also presents a few important, unmet questions related to the failure of progesterone treatment in alleviating clinical conditions in endometriosis.

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Condition tags

endometriosischronic_pelvic_paininfertility

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.

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last seen: 2026-06-10T17:14:06.276822+00:00
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