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Local estrogen production hastens prostaglandin synthesis by stimulating COX-2 activity, thus creating a self-perpetuating sequence of augmented estrogen formation and enhanced inflammation. Repetitive retrograde menstruation reintroduces aromatase-positive endometrial cells endowed with the capacity to implant and invade the peritoneum. In order to control endometriosis, an effective medication must inhibit aromatase, block COX-2, decrease fibrosis and induce amenorrhea. Within this framework, progestins, either alone or in the form of oral contraceptives, appear as first-line treatment for endometriosis owing to their capacity to block enzymes such as aromatase and COX-2. <\/jats:p>","DOI":"10.2217\/whe.12.52","type":"journal-article","created":{"date-parts":[[2012,11,26]],"date-time":"2012-11-26T14:34:27Z","timestamp":1353940467000},"page":"647-658","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":27,"title":["Role of Inflammation and Aromatase Expression in the Eutopic Endometrium and its Relationship with the Development of Endometriosis"],"prefix":"10.1177","volume":"8","author":[{"suffix":"Jr","given":"Hugo","family":"Maia","sequence":"first","affiliation":[{"name":"Centro de Pesquisas e Assist\u00eancia em Reprodu\u00e7\u00e3o Humana (CEPARH) & Instituto da Mulher, Rua Caetano Moura, 35, 40210-341 Salvador, Bahia, Brazil"},{"name":"Department of Gynecology, Obstetrics & Human Reproduction, Federal University of Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clarice","family":"Haddad","sequence":"additional","affiliation":[{"name":"Centro de Pesquisas & Assist\u00eancia em Reprodu\u00e7\u00e3o Humana (CEPARH), Salvador, Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Genevieve","family":"Coelho","sequence":"additional","affiliation":[{"name":"IVI Salvador, Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julio","family":"Casoy","sequence":"additional","affiliation":[{"name":"CEPARH, Salvador, Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2012,11,1]]},"reference":[{"key":"bibr1-WHE.12.52","unstructured":"Papers of special note have been highlighted as:"},{"key":"bibr2-WHE.12.52","unstructured":"of considerable interest"},{"key":"bibr3-WHE.12.52","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmi034"},{"key":"bibr4-WHE.12.52","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-05-0493"},{"key":"bibr5-WHE.12.52","unstructured":"Describes the link between inflammation, estrogens and the development of endometrial pathology."},{"key":"bibr6-WHE.12.52","doi-asserted-by":"publisher","DOI":"10.1080\/09513590802627647"},{"key":"bibr7-WHE.12.52","unstructured":"Suggests that aromatase expression in the eutopic endometrium is a key factor for the development of endometriosis, since estrogens are known to block macrophage phagocytosis function."},{"key":"bibr8-WHE.12.52","doi-asserted-by":"publisher","DOI":"10.1159\/000096047"},{"key":"bibr9-WHE.12.52","unstructured":"Describes the role of NF-\u03baB in stimulating the inflammatory cascade present in the endometriosis lesions."},{"key":"bibr10-WHE.12.52","doi-asserted-by":"publisher","DOI":"10.1262\/jrd.50.215"},{"issue":"1","key":"bibr11-WHE.12.52","first-page":"236","volume":"34","author":"Maia H","year":"2012","journal-title":"Giorn. 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