title: Effect of the menstrual cycle and oral contraceptives on aromatase and cyclooxygenase-2 expression in adenomyosis.
abstract: OBJECTIVE
  To determine whether aromatase expression in the eutopic endometrium and adenomyotic foci is affected by previous use of oral contraceptives containing gestodene, and to determine whether changes in cyclooxygenase-2 (COX-2) expression occur in adenomyosis during the menstrual cycle.
  
  
  METHODS
  This was a retrospective cohort study carried out in paraffin-embedded endometrial tissue obtained from patients with a histological diagnosis of adenomyosis obtained during the proliferative (n = 25) and luteal (n = 10) phases of the menstrual cycle and following the use of continuous oral contraception with gestodene/ethinyl estradiol (n = 7). COX-2 and aromatase expression were measured in both eutopic endometrium and adenomyotic foci using immunohistochemical methods.
  
  
  RESULTS
  Aromatase expression was detected in 80% of the endometrial slices by immunohistochemistry. In positive cases, aromatase was mainly detected in the stromal cells of the eutopic endometrium, whereas in the adenomyotic foci this expression was negative in the majority of the cases. Oral contraceptives containing gestodene, on the other hand, were effective in suppressing aromatase expression in both eutopic and ectopic endometrium. COX-2 expression was detected by immunohistochemistry in the glandular epithelium of both eutopic endometrium and adenomyotic foci and there were no significant changes in its intensity throughout the menstrual cycle.
  
  
  CONCLUSIONS
  Aromatase expression in the eutopic endometrium and adenomyotic foci is suppressed by oral contraceptives containing gestodene. Increased aromatase activity may be responsible for the persistent COX-2 expression during the luteal phase.
authors.affiliation: Centro de Pesquisa e Assistência em Reprodução Humana (CEPARH), Salvador, Bahia, Brazil. ceparh@uol.com.br
authors.forename: Hugo
authors.initials: H
authors.lastname: Maia
authors.forename: Julio
authors.initials: J
authors.lastname: Casoy
authors.forename: Tânia
authors.initials: T
authors.lastname: Correia
authors.forename: Luís
authors.initials: L
authors.lastname: Freitas
authors.forename: Kleber
authors.initials: K
authors.lastname: Pimentel
authors.forename: Célia
authors.initials: C
authors.lastname: Athayde
authors.forename: Elsimar
authors.initials: E
authors.lastname: Coutinho
mesh_terms: D000328:Adult; D001141:Aromatase / Q000378:metabolism*; D003276:Contraceptives, Oral / Q000494:pharmacology*; D051546:Cyclooxygenase 2 / Q000378:metabolism*; D004715:Endometriosis / Q000201:enzymology*; D004717:Endometrium / Q000201:enzymology; D005260:Female; D015870:Gene Expression / Q000187:drug effects; D006801:Humans; D008597:Menstrual Cycle / Q000502:physiology*; D008875:Middle Aged; D012189:Retrospective Studies; D014591:Uterine Diseases / Q000201:enzymology*
chemical_list: D003276:Contraceptives, Oral; D001141:Aromatase; D051546:Cyclooxygenase 2