title: Endometriosis: translation of molecular insights to management.
abstract: Endometriosis is a debilitating gynecologic disorder causing pelvic pain and infertility and characterized by the implantation of endometrial tissue to extrauterine locations. Though aspects of the condition remain enigmatic, the molecular pathophysiology of endometriosis appears to be clarifying. Estrogen dependence of the disease is a sentinel endocrine feature and reduction of estrogen bioavailability is the therapeutic principle upon which traditional treatment and prevention approaches have been based. Endometriosis is a chronic inflammatory condition associated with lesional neoangiogenesis and attenuated progesterone action at the level of the endometrium. The elucidation of the molecular pathways mediating these observations has revealed new targets for directed medical and surgical treatment. This paper will review current approaches to the management of endometriosis in the context of the molecular pathophysiology.
authors.affiliation: Department of Obstetrics and Gynecology Darnall Army Medical Center, Killeen, TX, USA - roburney@stanford.edu.
authors.forename: K L
authors.initials: KL
authors.lastname: Langan
authors.forename: M E
authors.initials: ME
authors.lastname: Farrell
authors.forename: E A
authors.initials: EA
authors.lastname: Keyser
authors.forename: B A
authors.initials: BA
authors.lastname: Salyer
authors.forename: R O
authors.initials: RO
authors.lastname: Burney
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003277:Contraceptives, Oral, Combined / Q000627:therapeutic use; D016207:Cytokines / Q000502:physiology; D003613:Danazol / Q000627:therapeutic use; D019468:Disease Management; D004715:Endometriosis / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D004717:Endometrium / Q000378:metabolism / Q000473:pathology; D004958:Estradiol / Q000502:physiology; D005260:Female; D005786:Gene Expression Regulation; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000503:physiopathology; D007249:Inflammation; D010535:Laparoscopy; D008262:Macrophage Activation; D016328:NF-kappa B / Q000378:metabolism; D009389:Neovascularization, Pathologic / Q000503:physiopathology; D034445:Ovulation Inhibition; D017699:Pelvic Pain / Q000188:drug therapy / Q000209:etiology; D011374:Progesterone / Q000502:physiology; D011372:Progestins / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic
chemical_list: D020533:Angiogenesis Inhibitors; D000894:Anti-Inflammatory Agents, Non-Steroidal; D003277:Contraceptives, Oral, Combined; D016207:Cytokines; D016328:NF-kappa B; D011372:Progestins; D007987:Gonadotropin-Releasing Hormone; D011374:Progesterone; D004958:Estradiol; D003613:Danazol