Reviewing the role of progesterone therapy in endometriosis

Abstract

Endometriosis is a benign, chronic inflammatory condition characterized by the presence and growth of endometrial implants outside the uterine cavity. The cause of endometriosis is multifactorial. It is due to the diversity of hypothesis and plausibility of hormonal alterations which could play a major role. Evidence has shown that progesterone resistance is a key factor for endometriosis sufferers. Medical therapy can avoid surgical intervention, which may lead to a reduced in ovarian reserve, and its effects of earlier menopause and reduced fecundity. Progesterone receptor isoform has provided new insight as the potential treatment. Progestin, anti-progestin and selective progesterone receptor modulators usage, which target these receptors, could avoid hypo-estrogenic side effects, which can be debilitating. Numerous types of these medications have been used on and off labeled to treat endometriosis with varying success. This review aims to consolidate series of clinical trials using progestins in endometriosis.

摘要

子宫内膜异位症是一个良性、慢性炎性疾病, 以子宫腔外子宫内膜植入物的存在和生长为特征。子宫内膜异位症的病因是多因素的。这是由于假设的多样性和激素改变的合理性起主要作用。证据表明孕酮抵抗是内异症患者的关键因素。药物治疗可避免手术干预, 后者可导致卵巢储备功能降低, 以及早绝经和生育力降低带来的影响。孕酮受体亚型作为潜在的治疗手段提供了新的认识。孕激素、抗孕激素和选择性孕激素受体调节剂的使用, 以这些受体为靶标, 可以避免使人衰弱的低雌激素的副作用。许多类型的药物已被用于治疗内异症, 并取得了不同的成功。这篇综述旨在内异症中使用孕激素的一系列临床试验。

Keywords:

• Endometriosis
• progesterone
• progesterone receptor
• progestin
• progesterone receptor isoform

Disclosure statement

We wish to confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome.

Additional information

Funding

This mini-review is in support of the molecular research being done on PR isoforms in endometriosis, which has received ethical approval and funding from our center: FFF-2017–045; and FRGS/1/2017/SKK08/UKM/01/4. This study was also supported by Fundamental Grant UKMMC and Fundamental Research Grant Malaysia.