Progestins for symptomatic endometriosis: a critical analysis of the evidence

Vercellini, Paolo; Cortesi, Ilenia; Crosignani, Pier Giorgio

doi:10.1016/s0015-0282(97)00193-3

Cited by 217 publications

(99 citation statements)

References 34 publications

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“…In the United States, endometriosis is the third most common gynecologic disorder that requires hospitalization and is a leading cause of hysterectomy. Only 50% of women with endometriosis achieve pain relief in response to existing hormonal treatments or conservative surgery (Vercellini et al, 1997). Thus, there is a clear need to develop novel and effective therapies for endometriosis.…”

Section: Aromatase and Endometriosismentioning

confidence: 99%

Regulation of Aromatase Expression in Estrogen-Responsive Breast and Uterine Disease: From Bench to Treatment

Bulun¹,

Lin²,

İmir³

et al. 2005

Pharmacol Rev

468

462

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Section: Aromatase and Endometriosismentioning

confidence: 99%

Regulation of Aromatase Expression in Estrogen-Responsive Breast and Uterine Disease: From Bench to Treatment

Bulun¹,

Lin²,

İmir³

et al. 2005

Pharmacol Rev

468

462

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“…Conditions of oestrogen excess have been reported to exacerbate endometriosis, while medical interventions that inhibit oestrogen production or action, i.e. down-regulating doses of gonadotrophin-releasing hormone (GnRH) analogues (Schriock et al, 1985), progestins (Vercellini et al, 1997), androgens (Barbieri et al, 1982) and anti-oestrogens (Haber and Behelak, 1987), ameliorate its symptoms.…”

Section: Introductionmentioning

confidence: 99%

Oestrogen receptor (ER)-alpha and ER- isoforms in normal endometrial and endometriosis-derived stromal cells

Brandenberger

Lebovic

Tee

et al. 1999

Molecular Human Reproduction

154

108

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Several investigators have noted that hormone-dependent development of endometriosis implants lags behind that of simultaneously analysed eutopic endometrium. With the recent discovery of the oestrogen receptor-β (ER-β) isoform, the aim of this study was to investigate whether differences in the expression of ER-α and ER-β might explain this observation. mRNA transcripts from endometrial stromal cells isolated from normal endometrium (NE) and from endometriomas (EI) were analysed using a semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR) technique. RT-PCR and Southern blot analyses of the two ER isoforms indicated that NE and EI stromal cells predominantly express ER-α mRNA, however the relative concentrations of ER isoform mRNA transcripts differed between the two cell types. Steady-state ER-α:ER-β mRNA ratios were 15.5 ⍨ 2.8 and 5.2 ⍨ 0.9 respectively for NE and EI cells (P ⍧ 0.02). NE and EI stromal cells expressed ER proteins with similar K d (~0.9 nM) and densities (~24 500 binding sites/cell) respectively. Functional ER expression was indicated by an increase in progesterone receptor concentrations of~60% (P ⍧ 0.03) after incubation with 10 nM oestradiol. We postulate that differential transcript processing, ligand specificity and biological actions of the ER-α and -β isoforms may influence differential growth responses in normal and ectopic endometrium.

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“…For empiric medical therapy, OCPs and medroxyprogesterone acetate have apparent therapeutic equivalence and should be used as first-line therapies. [24][25][26] Many sources support the empiric use of GnRHas for treatment of the pain associated with endometriosis; 27 however, a systematic review found them to be no more effective than OCPs or progestogens 24 (online Table A). Furthermore, GnRHas can have hypoestrogenic side effects.…”

Section: Diagnostic Strategymentioning

confidence: 99%