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Updated: Jul 14, 2026

Surgical Techniques to Optimize Ovarian Reserve during Laparoscopic Cystectomy for Ovarian Endometrioma
Published on: January 22, 2022
Aromatase inhibitors in the treatment of severe endometriosis
Noha A Mousa1, Mohamed A Bedaiwy, Robert F Casper
1Institute of Medical Science, Samuel Lunenfeld Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
Background:
Endometriosis-associated chronic pelvic pain unresponsive to surgical menopause is a difficult clinical problem.
Case:
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.
Conclusion:
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.
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