Aromatase inhibitors for the treatment of endometriosis: a systematic review about efficacy, safety and early clinical development

References

• Laganà AS, Vitale SG, Salmeri FM, et al. Unus pro omnibus, omnes pro uno: a novel, evidence-based, unifying theory for the pathogenesis of endometriosis. Med Hypotheses. 2017;103:10–20.
   PubMed Web of Science ®Google Scholar
• Missmer SA, Cramer DW. The epidemiology of endometriosis. Obstet Gynecol Clin North Am. 2003;30: 1–19vii.
   PubMed Web of Science ®Google Scholar
• Giudice LC. Clinical practice. Endometriosis. N Engl J Med. 2010;362:2389–2398.
   PubMed Web of Science ®Google Scholar
• Morotti M, Remorgida V, Venturini PL, et al. Endometriosis in menopause: a single institution experience. Arch Gynecol Obstet. 2012;286:1571–1575.
   PubMed Web of Science ®Google Scholar
• Johnson NP, Hummelshoj L, Adamson GD, et al. World Endometriosis Society consensus on the classification of endometriosis. Hum Reprod. 2017;32:315–324.
   PubMed Web of Science ®Google Scholar
• Apostolopoulos NV, Alexandraki KI, Gorry A, et al. Association between chronic pelvic pain symptoms and the presence of endometriosis. Arch Gynecol Obstet. 2016;293:439–445.
   PubMed Web of Science ®Google Scholar
• Howard FM. Endometriosis and mechanisms of pelvic pain. J Minim Invasive Gynecol. 2009;16:540–550.
   PubMed Web of Science ®Google Scholar
• Coxon L, Horne AW, Vincent K. Pathophysiology of endometriosis-associated pain: a review of pelvic and central nervous system mechanisms. Best Pract Res Clin Obstet Gynaecol. 2018;51:53–67.
   PubMed Web of Science ®Google Scholar
• Donnez J, Donnez O, Orellana R, et al. Endometriosis and infertility. Panminerva Med. 2016;58:143–150.
   PubMed Web of Science ®Google Scholar
• Terzic M, Aimagambetova G, Garzon S, et al. Ovulation induction in infertile women with endometriotic ovarian cysts: current evidence and potential pitfalls. Minerva Med. 2020;111:50–61.
   PubMed Web of Science ®Google Scholar
• Dunselman GAJ, Vermeulen N, Becker C, et al. ESHRE guideline: management of women with endometriosis. Hum Reprod. 2014;29:400–412.
   PubMed Web of Science ®Google Scholar
• Laganà AS, Vitale SG, Trovato MA, et al. Full-thickness excision versus shaving by laparoscopy for intestinal deep infiltrating endometriosis: rationale and potential treatment options. BioMed Res Int. 2016;2016:3617179.
   PubMed Web of Science ®Google Scholar
• Raffaelli R, Garzon S, Baggio S, et al. Mesenteric vascular and nerve sparing surgery in laparoscopic segmental intestinal resection for deep infiltrating endometriosis. Eur J Obstet Gynecol Reprod Biol. 2018;231:214–219.
   PubMed Web of Science ®Google Scholar
• Baggio S, Pomini P, Zecchin A, et al. Delivery and pregnancy outcome in women with bowel resection for deep endometriosis: a retrospective cohort study. Gynecol Surg. 2015;12:279–285.
   Web of Science ®Google Scholar
• Duffy JM, Arambage K, Correa FJ, et al. Laparoscopic surgery for endometriosis. Cochrane Database Syst Rev. 2014;4:CD011031.
   Google Scholar
• Butticè S, Laganà AS, Mucciardi G, et al. Different patterns of pelvic ureteral endometriosis What is the best treatment? Results of a retrospective analysis. Arch Ital Urol Androl Organo Uff Soc Ital Ecogr Urol E Nefrol. 2016;88:266–269.
   PubMedGoogle Scholar
• Šalamun V, Verdenik I, Laganà AS, et al. Should we consider integrated approach for endometriosis-associated infertility as gold standard management? Rationale and results from a large cohort analysis. Arch Gynecol Obstet. 2018;297:613–621.
   PubMed Web of Science ®Google Scholar
• Jacobson TZ, Duffy JM, Barlow D, et al. Laparoscopic surgery for subfertility associated with endometriosis. Cochrane Database Syst Rev. 2010:CD 001398.
   Web of Science ®Google Scholar
• Ferrero S, Alessandri F, Racca A, et al. Treatment of pain associated with deep endometriosis: alternatives and evidence. Fertil Steril. 2015;104:771–792.
   PubMed Web of Science ®Google Scholar
• Somigliana E, Vigano P, Benaglia L, et al. Management of endometriosis in the infertile patient. Semin Reprod Med. 2016;35:031–037.
   PubMed Web of Science ®Google Scholar
• Somigliana E, Benaglia L, Vigano’ P, et al. Surgical measures for endometriosis-related infertility: a plea for research. Placenta. 2011;32:S238–S242.
   PubMed Web of Science ®Google Scholar
• Yap C, Furness S, Farquhar C. Pre and post operative medical therapy for endometriosis surgery. Cochrane Database Syst Rev. 2004:CD 003678.
   Google Scholar
• Ferrero S, Evangelisti G, Barra F. Current and emerging treatment options for endometriosis. Expert Opin Pharmacother. 2018;19:1109–1125.
   PubMed Web of Science ®Google Scholar
• Laganà AS, Garzon S, Götte M, et al. The pathogenesis of endometriosis: molecular and cell biology insights. Int J Mol Sci. 2019;20:5615.
   PubMed Web of Science ®Google Scholar
• Riemma G, Laganà AS, Schiattarella A, et al. Ion channels in the pathogenesis of endometriosis: a cutting-edge point of view. Int J Mol Sci. 2020;21:1114.
   PubMed Web of Science ®Google Scholar
• Della Corte L, Noventa M, Ciebiera M, et al. Phytotherapy in endometriosis: an up-to-date review. J Complement Integr Med. 2019. DOI:10.1515/jcim-2019-0084
   Google Scholar
• Laganà AS, Garzon S, Casarin J, et al. Know your enemy: potential role of cabergoline to target neoangiogenesis in endometriosis. J Invest Surg. 2020;1–2. DOI:10.1080/08941939.2020.1725191
   Web of Science ®Google Scholar
• Berlanda N, Somigliana E, Viganò P, et al. Safety of medical treatments for endometriosis. Expert Opin Drug Saf. 2016;15:21–30.
   PubMed Web of Science ®Google Scholar
• Brown J, Kives S, Akhtar M. Progestagens and anti-progestagens for pain associated with endometriosis. Cochrane Database Syst Rev. 2012;CD 002122.
   Web of Science ®Google Scholar
• Vercellini P, Pietropaolo G, De Giorgi O, et al. Treatment of symptomatic rectovaginal endometriosis with an estrogen-progestogen combination versus low-dose norethindrone acetate. Fertil Steril. 2005;84:1375–1387.
   PubMed Web of Science ®Google Scholar
• Garzon S, Laganà AS, Barra F, et al. Novel drug delivery methods for improving efficacy of endometriosis treatments. Expert Opin Drug Deliv. 2020;27:1-3.
   PubMed Web of Science ®Google Scholar
• Laganà AS, Vitale SG, Granese R, et al. Clinical dynamics of Dienogest for the treatment of endometriosis: from bench to bedside. Expert Opin Drug Metab Toxicol. 2017;13:593–596.
   PubMed Web of Science ®Google Scholar
• Grandi G, Mueller MD, Bersinger NA, et al. The association between progestins, nuclear receptors expression and inflammation in endometrial stromal cells from women with endometriosis. Gynecol Endocrinol. 2017;33:712–715.
   PubMed Web of Science ®Google Scholar
• Barra F, Scala C, Ferrero S. Current understanding on pharmacokinetics, clinical efficacy and safety of progestins for treating pain associated to endometriosis. Expert Opin Drug Metab Toxicol. 2018;14:399–415.
   PubMed Web of Science ®Google Scholar
• Cetel NS, Rivier J, Vale W, et al. The dynamics of gonadotropin inhibition in women induced by an antagonistic analog of gonadotropin-releasing hormone. J Clin Endocrinol Metab. 1983;57:62–65.
   PubMed Web of Science ®Google Scholar
• Brown J, Pan A, Hart RJ. Gonadotrophin-releasing hormone analogues for pain associated with endometriosis. Cochrane Database Syst Rev. 2010:CD 008475.
   Web of Science ®Google Scholar
• Papanikolaou EG, Yarali H, Timotheou E, et al. A proof-of-concept clinical trial of a single luteal use of long-acting gonadotropin-releasing hormone antagonist degarelix in controlled ovarian stimulation for in vitro fertilization: long antagonist protocol. Front Endocrinol. 2018;9:25.
   PubMed Web of Science ®Google Scholar
• Abu Hashim H. Gonadotrophin-releasing hormone analogues and endometriosis: current strategies and new insights. Gynecol Endocrinol Off J Int Soc Gynecol Endocrinol. 2012;28:314–321.
   PubMed Web of Science ®Google Scholar
• Becker CM, Gattrell WT, Gude K, et al. Reevaluating response and failure of medical treatment of endometriosis: a systematic review. Fertil Steril. 2017;108:125–136.
   PubMed Web of Science ®Google Scholar
• Ferrero S, Remorgida V, Maganza C, et al. Aromatase and endometriosis: estrogens play a role. Ann N Y Acad Sci. 2014;1317:17–23.
   PubMed Web of Science ®Google Scholar
• Brandenberger AW, Lebovic DI, Tee MK, et al. Oestrogen receptor (ER)-alpha and ER-beta isoforms in normal endometrial and endometriosis-derived stromal cells. Mol Hum Reprod. 1999;5:651–655.
   PubMed Web of Science ®Google Scholar
• Burns KA, Rodriguez KF, Hewitt SC, et al. Role of estrogen receptor signaling required for endometriosis-like lesion establishment in a mouse model. Endocrinology. 2012;153:3960–3971.
   PubMed Web of Science ®Google Scholar
• Liu A, Guan Z, Zhang Z, et al. Study on expression of estrogen receptor isoforms in eutopic and ectopic endometrium of ovarian endometriosis. Zhonghua Bing Li Xue Za Zhi. 2008;37:584–588.
   PubMedGoogle Scholar
• Chan HJ, Petrossian K, Chen S. Structural and functional characterization of aromatase, estrogen receptor, and their genes in endocrine-responsive and -resistant breast cancer cells. J Steroid Biochem Mol Biol. 2016;161:73–83.
   PubMed Web of Science ®Google Scholar
• Simmen RCM, Kelley AS. Reversal of fortune: estrogen receptor-beta in endometriosis. J Mol Endocrinol. 2016;57:F23–F27.
   PubMed Web of Science ®Google Scholar
• Cowley SM, Hoare S, Mosselman S, et al. Estrogen receptors alpha and beta form heterodimers on DNA. J Biol Chem. 1997;272:19858–19862.
   PubMed Web of Science ®Google Scholar
• Maruyama T, Yoshimura Y. Molecular and cellular mechanisms for differentiation and regeneration of the uterine endometrium. Endocr J. 2008;55:795–810.
   PubMed Web of Science ®Google Scholar
• Bulun SE, Monsavais D, Pavone ME, et al. Role of estrogen receptor-β in endometriosis. Semin Reprod Med. 2012;30:39–45.
   PubMed Web of Science ®Google Scholar
• Planas-Silva MD, Weinberg RA. Estrogen-dependent cyclin E-cdk2 activation through p21 redistribution. Mol Cell Biol. 1997;17:4059–4069.
   PubMed Web of Science ®Google Scholar
• Cavallini A, Resta L, Caringella AM, et al. Involvement of estrogen receptor-related receptors in human ovarian endometriosis. Fertil Steril. 2011;96:102–106.
   PubMed Web of Science ®Google Scholar
• Han SJ, Jung SY, Wu S-P, et al. Estrogen receptor β modulates apoptosis complexes and the inflammasome to drive the pathogenesis of endometriosis. Cell. 2015;163:960–974.
   PubMed Web of Science ®Google Scholar
• Vetvicka V, Laganà AS, Salmeri FM, et al. Regulation of apoptotic pathways during endometriosis: from the molecular basis to the future perspectives. Arch Gynecol Obstet. 2016;294:897–904.
   PubMed Web of Science ®Google Scholar
• Salmeri FM, Laganà AS, Sofo V, et al. Behavior of tumor necrosis factor-α and tumor necrosis factor receptor 1/tumor necrosis factor receptor 2 system in mononuclear cells recovered from peritoneal fluid of women with endometriosis at different stages. Reprod Sci Thousand Oaks Calif. 2015;22:165–172.
   PubMed Web of Science ®Google Scholar
• Han SJ, Lee JE, Cho YJ, et al. Genomic function of estrogen receptor β in endometriosis. Endocrinology. 2019;160:2495–2516.
   PubMed Web of Science ®Google Scholar
• Shoham Z, Schachter M. Estrogen biosynthesis–regulation, action, remote effects, and value of monitoring in ovarian stimulation cycles. Fertil Steril. 1996;65:687–701.
   PubMed Web of Science ®Google Scholar
• Bulun SE. Endometriosis. N Engl J Med. 2009;360:268–279.
   PubMed Web of Science ®Google Scholar
• Kitawaki J, Noguchi T, Amatsu T, et al. Expression of aromatase cytochrome P450 protein and messenger ribonucleic acid in human endometriotic and adenomyotic tissues but not in normal endometrium. Biol Reprod. 1997;57:514–519.
   PubMed Web of Science ®Google Scholar
• Noble LS, Simpson ER, Johns A, et al. Aromatase expression in endometriosis. J Clin Endocrinol Metab. 1996;81:174–179.
   PubMed Web of Science ®Google Scholar
• Early Breast Cancer Trialists’ Collaborative Group (EBCTCG). Aromatase inhibitors versus tamoxifen in early breast cancer: patient-level meta-analysis of the randomised trials. Lancet Lond Engl. 2015;386:1341–1352.
   PubMed Web of Science ®Google Scholar
• Laganà AS, Unfer V. D-Chiro-Inositol’s action as aromatase inhibitor: rationale and potential clinical targets. Eur Rev Med Pharmacol Sci. 2019;23:10575–10576.
   PubMed Web of Science ®Google Scholar
• Noble LS, Takayama K, Zeitoun KM, et al. Prostaglandin E2 stimulates aromatase expression in endometriosis-derived stromal cells. J Clin Endocrinol Metab. 1997;82:600–606.
   PubMed Web of Science ®Google Scholar
• Kitawaki J, Kusuki I, Koshiba H, et al. Detection of aromatase cytochrome P-450 in endometrial biopsy specimens as a diagnostic test for endometriosis. Fertil Steril. 1999;72:1100–1106.
   PubMed Web of Science ®Google Scholar
• Velasco I, Rueda J, Acién P. Aromatase expression in endometriotic tissues and cell cultures of patients with endometriosis. Mol Hum Reprod. 2006;12:377–381.
   PubMed Web of Science ®Google Scholar
• Attar E, Tokunaga H, Imir G, et al. Prostaglandin E2 via steroidogenic factor-1 coordinately regulates transcription of steroidogenic genes necessary for estrogen synthesis in endometriosis. J Clin Endocrinol Metab. 2009;94:623–631.
   PubMed Web of Science ®Google Scholar
• Ferrero S, Gillott DJ, Remorgida V, et al. Proteomic analysis of peritoneal fluid in women with endometriosis. J Proteome Res. 2007;6:3402–3411.
   PubMed Web of Science ®Google Scholar
• Ferrero S, Gillott DJ, Anserini P, et al. Vitamin D binding protein in endometriosis. J Soc Gynecol Investig. 2005;12:272–277.
   PubMedGoogle Scholar
• Montagna P, Capellino S, Villaggio B, et al. Peritoneal fluid macrophages in endometriosis: correlation between the expression of estrogen receptors and inflammation. Fertil Steril. 2008;90:156–164.
   PubMed Web of Science ®Google Scholar
• Fichera M, Török P, Tesarik J, et al. Vitamin D, reproductive disorders and assisted reproduction: evidences and perspectives. Int J Food Sci Nutr. 2020;71:276–285.
   PubMed Web of Science ®Google Scholar
• Huhtinen K, Desai R, Ståhle M, et al. Endometrial and endometriotic concentrations of estrone and estradiol are determined by local metabolism rather than circulating levels. J Clin Endocrinol Metab. 2012;97:4228–4235.
   PubMed Web of Science ®Google Scholar
• Bulun SE, Yang S, Fang Z, et al. Role of aromatase in endometrial disease. J Steroid Biochem Mol Biol. 2001;79:19–25.
   PubMed Web of Science ®Google Scholar
• Delvoux B, Groothuis P, D’Hooghe T, et al. Increased production of 17beta-estradiol in endometriosis lesions is the result of impaired metabolism. J Clin Endocrinol Metab. 2009;94:876–883.
   PubMed Web of Science ®Google Scholar
• Colette S, Lousse JC, Defrère S, et al. Absence of aromatase protein and mRNA expression in endometriosis. Hum Reprod Oxf Eng. 2009;24:2133–2141.
   PubMed Web of Science ®Google Scholar
• Colette S, Donnez J. Are aromatase inhibitors effective in endometriosis treatment? Expert Opin Investig Drugs. 2011;20:917–931.
   PubMed Web of Science ®Google Scholar
• Fabian CJ. The what, why and how of aromatase inhibitors: hormonal agents for treatment and prevention of breast cancer. Int J Clin Pract. 2007;61:2051–2063.
   PubMed Web of Science ®Google Scholar
• Barra F, Romano A, Grandi G, et al. Future directions in endometriosis treatment: discovery and development of novel inhibitors of estrogen biosynthesis. Expert Opin Investig Drugs. 2019;28:501–504.
   PubMed Web of Science ®Google Scholar
• Sobral AF, Amaral C, Correia-da-Silva G, et al. Unravelling exemestane: from biology to clinical prospects. J Steroid Biochem Mol Biol. 2016;163:1–11.
   PubMed Web of Science ®Google Scholar
• Committee Opinion No. 663. Aromatase inhibitors in gynecologic practice. Obstet Gynecol. 2016;127:e170–174.
   PubMed Web of Science ®Google Scholar
• Cardoso F, Costa A, Senkus E, et al. 3rd ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 3). Ann Oncol Off J Eur Soc Med Oncol. 2017;28:16–33.
   PubMed Web of Science ®Google Scholar
• Cardoso F, Senkus E, Costa A, et al. 4th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 4)†. Ann Oncol Off J Eur Soc Med Oncol. 2018;29:1634–1657.
   PubMed Web of Science ®Google Scholar
• Ferreira Almeida C, Oliveira A, João Ramos M, et al. Estrogen receptor-positive (ER+) breast cancer treatment: are multi-target compounds the next promising approach? Biochem Pharmacol. 2020;177:113989.
   PubMed Web of Science ®Google Scholar
• Augusto TV, Correia-da-Silva G, Rodrigues CMP, et al. Acquired resistance to aromatase inhibitors: where we stand! Endocr Relat Cancer. 2018;25:R283–R301.
   PubMed Web of Science ®Google Scholar
• Hong AR, Kim JH, Lee KH, et al. Long-term effect of aromatase inhibitors on bone microarchitecture and macroarchitecture in non-osteoporotic postmenopausal women with breast cancer. Osteoporos Int J Establ Result Coop Eur Found Osteoporos Natl Osteoporos Found USA. 2017;28:1413–1422.
   PubMed Web of Science ®Google Scholar
• Amir E, Seruga B, Niraula S, et al. Toxicity of adjuvant endocrine therapy in postmenopausal breast cancer patients: a systematic review and meta-analysis. J Natl Cancer Inst. 2011;103:1299–1309.
   PubMed Web of Science ®Google Scholar
• Peters A, Tadi P. Aromatase inhibitors. StatPearls. Treasure Island (FL): StatPearls Publishing; 2020.
   Google Scholar
• Zeitoun KM, Bulun SE. Aromatase: a key molecule in the pathophysiology of endometriosis and a therapeutic target. Fertil Steril. 1999;72:961–969.
   PubMed Web of Science ®Google Scholar
• Takayama K, Zeitoun K, Gunby RT, et al. Treatment of severe postmenopausal endometriosis with an aromatase inhibitor. Fertil Steril. 1998;69:709–713.
   PubMed Web of Science ®Google Scholar
• Badawy AM, Elnashar AM, Mosbah AA. Aromatase inhibitors or gonadotropin-releasing hormone agonists for the management of uterine adenomyosis: a randomized controlled trial. Acta Obstet Gynecol Scand. 2012;91:489–495.
   PubMed Web of Science ®Google Scholar
• Ailawadi RK, Jobanputra S, Kataria M, et al. Treatment of endometriosis and chronic pelvic pain with letrozole and norethindrone acetate: a pilot study. Fertil Steril. 2004;81:290–296.
   PubMed Web of Science ®Google Scholar
• Amsterdam LL, Gentry W, Jobanputra S, et al. Anastrazole and oral contraceptives: a novel treatment for endometriosis. Fertil Steril. 2005;84:300–304.
   PubMed Web of Science ®Google Scholar
• Hefler LA, Grimm C, van Trotsenburg M, et al. Role of the vaginally administered aromatase inhibitor anastrozole in women with rectovaginal endometriosis: a pilot study. Fertil Steril. 2005;84:1033–1036.
   PubMed Web of Science ®Google Scholar
• Remorgida V, Abbamonte LH, Ragni N, et al. Letrozole and desogestrel-only contraceptive pill for the treatment of stage IV endometriosis. Aust N Z J Obstet Gynaecol. 2007;47:222–225.
   PubMed Web of Science ®Google Scholar
• Remorgida V, Abbamonte HL, Ragni N, et al. Letrozole and norethisterone acetate in rectovaginal endometriosis. Fertil Steril. 2007;88:724–726.
   PubMed Web of Science ®Google Scholar
• Lossl K, Loft A, Freiesleben NLC, et al. Combined down-regulation by aromatase inhibitor and GnRH-agonist in IVF patients with endometriomas-A pilot study. Eur J Obstet Gynecol Reprod Biol. 2009;144:48–53.
   PubMed Web of Science ®Google Scholar
• Ferrero S, Camerini G, Ragni N, et al. Letrozole and norethisterone acetate in colorectal endometriosis. Eur J Obstet Gynecol Reprod Biol. 2010;150:199–202.
   PubMed Web of Science ®Google Scholar
• Agarwal SK, Foster WG. Reduction in endometrioma size with three months of aromatase inhibition and progestin add-back. BioMed Res Int. 2015;2015:878517.
   PubMed Web of Science ®Google Scholar
• Ferrero S, Camerini G, Seracchioli R, et al. Letrozole combined with norethisterone acetate compared with norethisterone acetate alone in the treatment of pain symptoms caused by endometriosis. Hum Reprod Oxf Eng. 2009;24:3033–3041.
   PubMed Web of Science ®Google Scholar
• Ferrero S, Leone Roberti Maggiore U, Scala C, et al. Changes in the size of rectovaginal endometriotic nodules infiltrating the rectum during hormonal therapies. Arch Gynecol Obstet. 2013;287:447–453.
   PubMed Web of Science ®Google Scholar
• Ferrero S, Remorgida V, Venturini PL, et al. Norethisterone acetate versus norethisterone acetate combined with letrozole for the treatment of ovarian endometriotic cysts: a patient preference study. Eur J Obstet Gynecol Reprod Biol. 2014;174:117–122.
   PubMed Web of Science ®Google Scholar
• Roghaei MA, Tehrany HG, Taherian A, et al. Effects of letrozole compared with danazol on patients with confirmed endometriosis: a randomized clinical trial. Int J Fertil Steril. 2010;4:67–72.
   Web of Science ®Google Scholar
• Alborzi S, Hamedi B, Omidvar A, et al. A comparison of the effect of short-term aromatase inhibitor (letrozole) and GnRH agonist (triptorelin) versus case control on pregnancy rate and symptom and sign recurrence after laparoscopic treatment of endometriosis. Arch Gynecol Obstet. 2011;284:105–110.
   PubMed Web of Science ®Google Scholar
• Ferrero S, Venturini PL, Gillott DJ, et al. Letrozole and norethisterone acetate versus letrozole and triptorelin in the treatment of endometriosis related pain symptoms: a randomized controlled trial. Reprod Biol Endocrinol RBE. 2011;9:88.
   PubMed Web of Science ®Google Scholar
• Soysal S, Soysal ME, Ozer S, et al. The effects of post-surgical administration of goserelin plus anastrozole compared to goserelin alone in patients with severe endometriosis: a prospective randomized trial. Hum Reprod Oxf Eng. 2004;19:160–167.
   PubMed Web of Science ®Google Scholar
• Nawathe A, Patwardhan S, Yates D, et al. Systematic review of the effects of aromatase inhibitors on pain associated with endometriosis. BJOG Int J Obstet Gynaecol. 2008;115:818–822.
   PubMed Web of Science ®Google Scholar
• Biberoglu KO, Behrman SJ. Dosage aspects of danazol therapy in endometriosis: short-term and long-term effectiveness. Am J Obstet Gynecol. 1981;139:645–654.
   PubMed Web of Science ®Google Scholar
• Buggio L, Lazzari C, Monti E, et al. “Per vaginam” topical use of hormonal drugs in women with symptomatic deep endometriosis: a narrative literature review. Arch Gynecol Obstet. 2017;296:435–444.
   PubMed Web of Science ®Google Scholar
• Schultze-Mosgau M-H, Waellnitz K, Nave R, et al. Pharmacokinetics, pharmacodynamics, safety and tolerability of an intravaginal ring releasing anastrozole and levonorgestrel in healthy premenopausal women: a Phase 1 randomized controlled trial. Hum Reprod Oxf Eng. 2016;31:1713–1722.
   PubMed Web of Science ®Google Scholar
• Reinecke I, Schultze-Mosgau M-H, Nave R, et al. Model-based dose selection for intravaginal ring formulations releasing anastrozole and levonorgestrel intended for the treatment of endometriosis symptoms. J Clin Pharmacol. 2017;57:640–651.
   PubMed Web of Science ®Google Scholar
• Pavone ME, Bulun SE. Aromatase inhibitors for the treatment of endometriosis. Fertil Steril. 2012;98:1370–1379.
   PubMed Web of Science ®Google Scholar
• Polyzos NP, Fatemi HM, Zavos A, et al. Aromatase inhibitors in post-menopausal endometriosis. Reprod Biol Endocrinol RBE. 2011;9:90.
   PubMed Web of Science ®Google Scholar