Pluchino N, Mamillapalli R, Wenger JM, et al. - Researchers examined if and how steroid receptor expression is associated with pain symptoms in endometriosis. In this cross-sectional study, 92 women with endometriosis were included. Tissue samples obtained from patients with surgically diagnosed endometriosis was used to generate a tissue microarray (TMA). Data concerning the presence and severity of dysmenorrhea, deep dyspareunia, dyschezia, and nonmenstrual pain were obtained by using a numerical rating scale (NRS) at the time of surgery and after 1 year. Findings revealed expression of ER-α, PR, AR, and aromatase in deep endometriosis. Best correlation was observed between ER-α levels and severity of symptoms. This indicates that ER is a key driver of deep endometriosis. A reduction of ER-α expression was observed after proving progestin treatment; however, there was also predictive value of failure of ER suppression by progestins for pain severity and recurrence at 1 year. .