In a further twist, the researchers uncovered that as this enzyme is induced by large amounts of inflammatory prostaglandins produced in the area, thus forming a vicious cycle to make its own estrogen and promote its own further growth. Therefore, the research explains why despite surgery, hormone treatments and hysterectomies, many women continue to suffer with symptoms of Endometriosis such as severe recurrent pelvic pain. On the basis of these findings, the team conducted preliminary research on the use of Aromatase Inhibitors as a treatment for Endometriosis. Due to these promising results, Dr. Bulun and his team are conducting a nationwide study on the use of Aromatase Inhibitors as a treatment for recurrent, progressive Endometriosis. Supported, in part, by an unrestricted grant from the American Society for Reproductive Medicine and Organon, Inc., the study raises important questions about the relationship of estrogen to Endometriosis.
Endometriosis is clearly an estrogen-dependent disease.
Estrogen for Endometriosis is like fuel for fire. It has been classically assumed that estrogen is produced primarily in the ovaries of premenopausal women with Endometriosis, and thus GnRH agonists temporarily suppress Endometriosis in the majority but not all of these patients. Unfortunately, Endometriosis recurs in most of these patients treated with GnRH agonists. We recently demonstrated that estrogen is produced also in the endometriotic implants in the pelvis or other sites through the expression of the enzyme named Aromatase, i.e., estrogen synthase. Prostaglandins in endometriotic cells stimulate Aromatase activity to increase estrogen biosynthesis.