This review confirms that despite decades of intensive research, the involvement of the immune system remains elusive, as we can recognize the changes, but still do not understand if these changes represent the results of endometriosis or if they are contributing factors. Based on these findings, we also discuss new treatment possibilities.

The endometrium tissue is functionally androgen related which plays an important role in women's fertility regulation. In addition recent findings show that endometrium related pathology is closely linked to disrupted androgen biosynthesis and associated regulatory functions. These findings also suggest that androgens might play an important role in endometrium related cancer pathology with significant implications for treatment.Based on these findings, we have assessed 50 female outpatients with endometriosis and the clinical investigations were focused on biochemical serum analysis of DHEAS, oncological markers CA-125 and CA 19-9, estradiol, thyreothropic hormone, and prolactin.The results show significant Spearman correlations of CA-125 and CA 19-9 with dehydroepiandrosterone- DHEA-S (R = 0.52 resp. R = 0.49).This result represents 1st reported finding documenting androgen related increase of CA-125 and CA 19-9 levels as significant markers of endometrium pathology and it is possible to assume that these potential biomarkers could have clinical importance with respect to timely diagnosis.

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Endometriosis is described as the presence of both endometrial glandular and stromal cells outside the uterine cavity. A major characterization of this disease is ectopic implantation of endometrial cells with increased migration. It is one of the leading causes of morbidity among premenopausal women, with a prevalence of 10-16% of women of reproductive age. Despite over century of intensive research, none of the current treatment options represents a real cure. Based on the current knowledge, endometriosis, particularly its atypical version, is considered to be a transitional form from benign disease to tumour. However, the exact mechanisms of this conversion are still not fully established.

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Aim. Endometriosis is an inflammatory condition that shares a number of similarities with malignant diseases, such as an abnormal morphology, migration along the nerve bundles and metastatic spread to lymph nodes and distant organs. Endometriotic lesions are associated with oestrogen and progesterone imbalance which seems to play a key role in the pathogenesis of endometriosis. The aim of this study was to compare the status of both oestrogen and progesterone receptors in tissue of deep infiltrating endometriosis, lymph node endometriosis and atypical ovarian endometriosis using immunohistochemical methods, as well as to investigate the relationship between endometriosis and protein p53. Methods. A total of 40 cases with deep infiltrating endometriosis were included in our study. Based on histopathological analysis of resected specimens, the cases were divided into 2 groups: group 1-lymph node endometriosis (cases with lymph node involvement; n=12) and group 2-deep infiltrating endometriosis (cases without lymph node involvement; n=28). As a control group, eutopic endometrium of adenomyosis-and endometriosis-free women were used (n=16). Five cases of atypical ovarian endometriosis as well as descriptions of the nerve involvement in endometriosis were also included. Immunohistochemical staining with a total of 4 markers was performed-oestrogen and progesterone receptors (ER, PR), p53 and Ki-67 (proliferation index). Results. The immunophenotype of the cases in groups 1 and 2 and in the control group was virtually identical in the proliferative phase-strong nuclear ER and PR expression in more than 90% of endometrial glandular and stromal cells. In the early and mid secretory phase, ER expression only slightly decreased (80%) in endometrial glandular cells in group 2 and the control group, whereas in the late secretory phase, significant decrease of ER expression only in the control group was observed (15-50%; P<0.001). In group 2 and the control group, significant decrease of PR expression only in endometrial glandular cells was observed in the mid and late secretory phase (less than 15%; P<0.001). Differences in receptor content were found only in isolated cases in group 2. In group 1, no secretory changes were found. In all three groups, sporadic and weak nuclear p53 expression in less than 3% in both endometrial glandular and stromal cells was detected (regardless of the phase of the menstrual cycle). In atypical ovarian endometriosis, higher and strong p53 expression (on average 26%) and decrease in ER (on average 56%) and PR (less than 1%) expression was observed; compared to the control group and groups 1 and 2, the differences for all 3 markers were highly significant (P<0.001). In all groups, the proliferation index (Ki-67) reached the highest values in the proliferation phase and decreased during the cycle. However, in endometriotic tissue, it was widely variable in the individual phases of the cycle. Perineural spread of endometriosis with significant neural hypertrophy, hyperplasia and involvement of th...

Background:Endometrial tissue plays an important role in the regulation of female fertility and there is evidence that endometrial pathology (including endometriosis) is closely related to endocrine disorders. On the other hand, various neuroendocrine changes can be significantly affected by psychosocial stress. In connection with these findings, we tested the relationship between neuroendocrine changes, sexual dysfunction, psychosocial/traumatic stress, and dissociative symptoms in women with endometriosis.Methods:A total of 65 patients with endometriosis were included in the study. Clinical examinations were focused on the biochemical analysis of neuroendocrine markers of endometriosis (cancer antigen 125 [CA 125] and cancer antigen 19-9 [CA 19-9]), estradiol, psychometric evaluation of sexual dysfunction, psychosocial/traumatic stress, and dissociative symptoms.Results:The results showed significant Spearman correlations between the values of the revised range of sexual difficulties for sexual dysfunction (Revised Female Sexual Distress Scale), psychosocial/traumatic stress (Trauma Symptoms Checklist) (R = 0.31), and dissociative symptoms (Somatoform Dissociation Questionnaire) (R = 0.33). Positive correlations were also found between CA 125 and CA 19-9 (R = 0.63), and between CA 125 and the results of the values of the revised scale of sexual difficulties for sexual dysfunction (Revised Female Sexual Distress Scale) (R = 0.29). Also psychosocial/traumatic stress (Trauma Symptoms Checklist) significantly correlated with CA 125 (R = 0.38) and with CA 19-9 (R = 0.33).Conclusion:These results represent the first findings regarding the relationship of the neuroendocrine markers CA 125 and CA 19-9 and sexual dysfunction with trauma/stress-related symptoms and dissociative symptoms in women with endometriosis.

One of the most common sexual dysfunctional diseases in adult males is premature ejaculation. So far, there is no evidence of how premature ejaculation is associated with psychosocial stress. We tested the relationship between neuroendocrine changes in patients with premature ejaculation and indicators of stress experience as a new psychosomatic hypothesis where psychosocial stress may significantly contribute to the aetiology of premature ejaculation. A total of 55 patients with premature ejaculation were included in the study. The control group consisted of 55 healthy men. The diagnosis of premature ejaculation was confirmed by a sexology examination, a history of patients and the values of the premature ejaculation diagnostic tool questionnaire. Comprehensive biochemical serum analysis was focused on the values of total testosterone, free testosterone, luteinising hormone, thyroid‐stimulating hormone, dehydroepiandrosterone sulphate, sex hormone‐binding globulin and a premature ejaculation diagnostic tool score with trauma symptom checklist and somatoform dissociation questionnaire. The results show significant Spearman correlations of trauma symptom checklist with the premature ejaculation diagnostic tool score (R = 0.84) and free testosterone (R = 0.62) and somatoform dissociation questionnaire with the premature ejaculation diagnostic tool score (R = 0.53) and free testosterone (R = 0.57). Spearman correlations of trauma symptom checklist with somatoform dissociation questionnaire show significant correlation (R = 0.54).