Related Experiment Video
Updated: Jul 7, 2026
Establishment of an Experimental Mouse Model of Endometrioma to Study its Related Infertility
Published on: April 5, 2024
Does response to hormonal therapy predict presence or absence of endometriosis?
Todd R Jenkins1, C Y Liu, John White
1Chattanooga Women's Laser Center, Chattanooga, Tennessee, USA. todd.jenkins@obgyn.uab.edu
Study Objective:
We sought to determine whether relief of chronic pelvic pain symptoms with hormonal treatment is predictive of presence or absence of endometriosis or location of endometriosis within the pelvis.
Design:
A retrospective, chart review (Canadian Task Force classification II-3).
Setting:
A private practice endometriosis referral center.
Patients:
Patients undergoing laparoscopy for pelvic pain with at least 3 months of previous hormonal treatment.
Interventions:
Laparoscopy.
Measurements And Main Results:
Response to hormonal treatment was ascertained by patient report in medical records. Presence and location of endometriosis was recorded based on operative findings and pathology reports. In all, 486 patients with chronic pelvic pain were identified, of whom 104 met our inclusion criteria. Endometriosis was diagnosed at laparoscopy in 88 (85%) patients. Endometriosis was identified at laparoscopy in 46 (81%) of 57 patients who failed to respond to hormonal therapy compared with 41 (87%) of 47 patients who previously responded to hormonal therapy (p = .37). Using final pathology as basis of diagnosis, 31 (67%) of 46 responders, and 39 (68%) of 57 nonresponders had endometriosis (p = .91). When data were analyzed by anatomic site of endometriosis, no significant difference was noted in response to preoperative hormonal therapy.
Conclusion:
Relief of chronic pelvic pain symptoms, or lack of response, with preoperative hormonal therapy is not an accurate predictor of presence or absence of histologically confirmed endometriosis at laparoscopy. Patients with chronic pelvic pain may benefit from laparoscopy and no judgment regarding diagnosis should be made without this evaluation.
Related Concept Videos
01:22Hormonal Regulation of the Menstrual Cycle
At puberty, GnRH begins a pulsatile release pattern, which triggers the anterior pituitary gland to secrete follicle-stimulating hormone (FSH) and luteinizing hormone (LH). The frequency and amplitude of GnRH pulses vary across the menstrual cycle, with faster pulses favoring LH release and slower pulses favoring FSH release.
01:22Target Cell Response to Hormones
Notably, the cellular response can be regulated by altering the number of receptors expressed in the cell. For example, prolonged exposure to elevated hormone levels results in a gradual decline or down-regulation in the number of receptors for that specific hormone on the cell surface. Conversely, in response to low hormone levels, cells may use up-regulation, producing an...
02:07Oogenesis
01:30Hormonal Control of the Ovarian Cycle
Before puberty, the hypothalamus releases GnRH in a low frequency, low amplitude pulsatile manner. This along with the immature hypothalamic-pituitary-gonadal axis activity, results in low estrogen levels and the absence of a fully functional ovarian cycle. At puberty, GnRH secretion increases in both frequency and...
01:08Chemical Signaling in the Endocrine System
Lipid-soluble hormones, such as steroid hormones, demonstrate an intracellular action. These hormones traverse cell membranes due to their lipid nature. Once inside the target cell, they...