Progesterone and estrogen signaling in the endometrium: What goes wrong in endometriosis?

Ryan M. Marquardt, Tae Hoon Kim, Jung Ho Shin, Jae Wook Jeong

    Research output: Contribution to journalReview articlepeer-review

    188 Citations (Scopus)


    In the healthy endometrium, progesterone and estrogen signaling coordinate in a tightly regulated, dynamic interplay to drive a normal menstrual cycle and promote an embryo-receptive state to allow implantation during the window of receptivity. It is well-established that progesterone and estrogen act primarily through their cognate receptors to set off cascades of signaling pathways and enact large-scale gene expression programs. In endometriosis, when endometrial tissue grows outside the uterine cavity, progesterone and estrogen signaling are disrupted, commonly resulting in progesterone resistance and estrogen dominance. This hormone imbalance leads to heightened inflammation and may also increase the pelvic pain of the disease and decrease endometrial receptivity to embryo implantation. This review focuses on the molecular mechanisms governing progesterone and estrogen signaling supporting endometrial function and how they become dysregulated in endometriosis. Understanding how these mechanisms contribute to the pelvic pain and infertility associated with endometriosis will open new avenues of targeted medical therapies to give relief to the millions of women suffering its effects.

    Original languageEnglish
    Article number3822
    JournalInternational journal of molecular sciences
    Issue number15
    Publication statusPublished - 2019 Aug 1

    Bibliographical note

    Funding Information:
    Research reported in this publication was supported in part by the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health under Award Numbers R01HD084478 and T32HD087166 as well as MSU AgBio Research and Michigan State University. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

    Publisher Copyright:
    © 2019 by the authors. Licensee MDPI, Basel, Switzerland.


    • Endometriosis
    • Endometrium
    • Estrogen
    • Infertility
    • Progesterone
    • Progesterone resistance

    ASJC Scopus subject areas

    • Catalysis
    • Molecular Biology
    • Spectroscopy
    • Computer Science Applications
    • Physical and Theoretical Chemistry
    • Organic Chemistry
    • Inorganic Chemistry


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