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The lack of cyclic variation in the concentrations of ERc and PRc is additional evidence that the hormonal control of endometriotic tissue is different from that in uterine endometrium. The lack of response of 17{3-HSD in endometriotic tissue to elevated progesterone concentrations in the latter part of the menstrual cycle, and to the administration of MP A, danazol and gestrinone, confirmed the unresponsive state of endometriotic tissue. As it has been shown that MPA, danazol and gestrinone all induce 17{3-HSD in the endometrium, these data suggest that mechanisms other than those mediated via female steroid hormone receptors are involved in the transmission of the therapeutic adions of these drugs in endometriotic tissue.
They are found only in tissues sensitive to steroid hormones. For several years the steroid receptors were regarded as localized mainly to the cytoplasm, where they were thought to bind to the hormone. The steroid-receptor complex was then transported to the nucleus, where it bound the chromatin chain. Thus, initially most studies on steroid receptors were performed in cytosol. In recent years, our knowledge in steroid receptors has changed and today we know that steroid receptors, both in the presence and in the absence of steroids, reside mainly in the nuclear compartment of target cells 4 -6.
Therefore, apoptosis is rather uncommon while the number of intra-epithelial phagocytes is not substantially increased. It may thus be concluded that epithelial cellular involution mainly proceeds by autophagy. This cellular involution can be achieved by a short-term medical therapy. There is no evidence that a long-term therapy will significantly enhance the regressive changes. 5 mg gestrinone twice or thrice weekly or danazol (600 mg daily) 12. THE AFS CLASSIFICATION SYSTEM The extent of endometriosis is usually staged by the American Fertility Society Classification System.