title: Aromatase inhibitors in the treatment of severe endometriosis.
abstract: BACKGROUND
  Endometriosis-associated chronic pelvic pain unresponsive to surgical menopause is a difficult clinical problem.
  
  
  METHODS
  A middle-aged woman presented with endometriosis and severe pelvic pain after hysterectomy and bilateral salpingo-oopherectomy. She was first treated with exemestane without improvement of symptoms. However, another aromatase inhibitor, letrozole, relieved her pain, and concomitant treatment with estrogen relieved hot flushes without pain reactivation.
  
  
  CONCLUSIONS
  Letrozole was superior to exemestane in relieving the endometriosis-associated pain in this postmenopausal woman. This suggests that patients may respond variably to different aromatase inhibitors.
authors.affiliation: Institute of Medical Science, Samuel Lunenfeld Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Noha A
authors.initials: NA
authors.lastname: Mousa
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Bedaiwy
authors.forename: Robert F
authors.initials: RF
authors.lastname: Casper
mesh_terms: D000730:Androstadienes / Q000627:therapeutic use; D047072:Aromatase Inhibitors / Q000627:therapeutic use*; D002908:Chronic Disease; D004715:Endometriosis / Q000150:complications* / Q000601:surgery; D015914:Estrogen Replacement Therapy; D005260:Female; D019584:Hot Flashes / Q000188:drug therapy / Q000517:prevention & control; D006801:Humans; D007044:Hysterectomy; D000077289:Letrozole; D008875:Middle Aged; D009570:Nitriles / Q000627:therapeutic use*; D017699:Pelvic Pain / Q000188:drug therapy* / Q000209:etiology; D017698:Postmenopause; D016896:Treatment Outcome; D014230:Triazoles / Q000627:therapeutic use*
chemical_list: D000730:Androstadienes; D047072:Aromatase Inhibitors; D009570:Nitriles; D014230:Triazoles; D000077289:Letrozole; C056516:exemestane