Perturbations in Progesterone Receptor Isoforms in Endometriosis

OBJECTIVE: To consolidate a series of trials in endometriosis patients with endometrioma and how progesterone receptor isoforms may vary. Endometriosis can be a debilitating condition which poses a challenge for treatment. Surgical options may not be suitable for some patients. Medical treatment using progestin is a modality for treating this potentially incapacitating condition. It acts via progesterone receptor which has 2 isoforms. Perturbation in the isoform expression is believed to be one of the mechanisms of progesterone resistance, which is postulated as a cause of endometriosis. STUDY DESIGN: A systematic review was performed using Medline and Scopus databases. RESULTS: Six papers were included in the final analysis.The expression of progesterone receptor isoforms was found to vary depending on the menstrual cycle,anatomical sites, and progestin treatment. CONCLUSION: The expression of progesterone receptors and their isoform ratios are significantly changed incertain phases of the menstrual cycle and with progestin use. Further clinical studies are required to confirm the plausibility that one isoform is a repressor of the other and that progestin helps improve progesterone resistance.