The role of progesterone and estrogen receptors in treatment choice after endometriosis surgery: A cross-sectional study

Poordast T, Tahereh Poordast, Alborzi S, Saeed Alborzi, Ziba Kiani, Kiani Z, Navid Omidifar, Omidifar N, Elham Askary, Chamanara K, Kefayat Chamanara, Mansoureh Shokripour, Shokripour M, Alimohammad Keshtvarz Hesam Abadi
International journal of reproductive biomedicine · 2024 · vol. 22(7) , pp. 567–578 · doi:10.18502/ijrm.v22i7.16970 · PMID:39355309 · PMC11441281 · W4402800787
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study analyzed hormone receptor levels in endometriotic lesions to identify optimal post-surgical medical treatments for pain relief, finding that oral contraceptives were best for dysmenorrhea and progesterone for dyspareunia.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-08 · read from full text ⓘ

This cross-sectional study evaluated the role of progesterone and estrogen receptors in determining treatment choice after endometriosis surgery, using participants who had undergone surgical management for endometriosis. The key finding was that receptor-related considerations were associated with how post-surgical treatment decisions were made. A major caveat is that the cross-sectional design limits causal interpretation of how receptor status influences treatment selection. This paper is centrally about endometriosis — it examines progesterone and estrogen receptor–related factors guiding treatment choice after endometriosis surgery.

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Abstract

BACKGROUND: The lack of improvement in some endometriotic people's pain after surgery even while using hormone treatment may suggest an inappropriate response to routine hormonal therapies. OBJECTIVE: This study aimed to determine a cut-off point for selecting the most appropriate treatment based on the hormone receptors of endometriotic lesions. MATERIALS AND METHODS: In this cross-sectional study, by reviewing the medical records of participants and testing their archive samples and phone interviews (if needed), 86 symptomatic women after endometriosis surgery who were operated into governmental hospitals, Shahid Faghihi and Hazrate Zeinab Shiraz Iran were enrolled between March 2017 and March 2019. Women were divided into 2 groups: responsiveness (n = 73 for dysmenorrhea, n = 60 for dyspareunia) to medical treatment and surgery, and unresponsiveness (n = 13, n = 7). We examined the pathological slides of 86 women to determine the amount of hormone receptors and the relationship between the type of medical treatment and the level of hormone receptors on pain relief within 1 yr after surgery. RESULTS: Based on the receiver operating characteristic curve, dysmenorrhea in the presence of tissue estrogen receptors > 60% (p = 0.1065), and dyspareunia in the presence of tissue progesterone receptors > 80% (p = 0.0001) responded well to medical treatment after surgery. In the presence of endometrioma-dysmenorrhea showed the best response to oral contraceptive pills (69.4%), while in deep infiltrative endometriosis-dyspareunia showed the best response to progesterone treatment (75%). CONCLUSION: Prescribing an appropriate hormone therapy based on a specific immunohistochemistry staining pattern can improve the life quality of postoperative endometriosis individuals.
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Section

Tahereh Poordast: Conception and design of study, Saeed Alborzi: Conception and design of study, Navid Omidfar: Conception, design of study, and patient recruitment, Kefayat Chamanara: Patient recruitment, and manuscript preparation, Mansoureh Shokripour: Conception and design of study, and patient recruitment. Ziba Kiani: Patient recruitment & data collection. Elham Askary: Conception, design of study, final approach, data interpretation, and manuscript preparation. Alimohammad Keshtvarz Hesam Abadi: Data analysis, interpretation, and final approach.

Coi Statement

The authors declare that there is no conflict of interest.

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Outcome instruments

VAS-pain

Condition tags

endometriosisendometriomadysmenorrheadyspareunia

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