Estrogen production and metabolism in endometriosis

Serdar E. Bulun*, Sijun Yang, Zhojuan Fang, Bilgin Gurates, Mitsutoshi Tamura, Siby Sebastian

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

121 Scopus citations


Aromatase activity is absent in normal endometrium. In contrast, aromatase is expressed aberrantly in endometriosis, which gives rise to strikingly high levels of aromatase activity in this tissue. Both aromatase expression and activity are stimulated by PGE2. This results in local production of estrogen, which induces PGE2 formation and establishes a positive feedback cycle. Another abnormality in endometriosis, that is, deficient 17β-HSD type 2 expression, impairs the inactivation of estradiol to estrone. These molecular aberrations collectively favor accumulation of increasing quantities of estradiol and PGE2 in endometriosis. The clinical relevance of these findings was exemplified by the successful treatment of an unusually aggressive case of postmenopausal endometriosis using an aromatase inhibitor.

Original languageEnglish (US)
Pages (from-to)75-85
Number of pages11
JournalAnnals of the New York Academy of Sciences
StatePublished - Jan 1 2002


  • 17β-hydroxysteroid dehydrogenase type 2
  • Aromatase
  • Aromatase inhibitor
  • Endometriosis
  • Estrogen
  • Estrogen biosynthesis
  • Estrogen metabolism
  • Osteoporosis
  • Progesterone
  • Steroidogenesis

ASJC Scopus subject areas

  • Neuroscience(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • History and Philosophy of Science


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