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子宫内膜异位症(EM)为雌激素依赖性疾病。治疗EM的中心法则是使雌激素的产生与作用减少(双侧卵巢切除、促性腺激素释放激素激动剂GnRHa),或增加雄激素作用(丹那唑、甲睾)。双侧卵巢切除后低剂量雌激素治疗不会引起子宫内膜异位症明显的盆腔疼痛复发。这些临床观察构成雌激素阈值理论的基础。正常月经周期中,雌二醇(E_2)浓度范围50～300pg/ml,在此范围内刺激EM病变的生长与功能。双侧卵巢切除后,E_2浓度降至5～15pg/ml,这样低的水平使异位内膜病变萎缩,但是低激素状态使骨丢失加速并有血管运动症状。
Endometriosis (EM) is an estrogen-dependent disease. Central to the treatment of EM is a reduction in estrogen production and effects (bilateral ovariectomy, gonadotropin-releasing hormone agonist GnRHa), or increased androgenic effects (danazol, testosterone). Low-dose estrogen therapy after bilateral ovariectomy does not cause significant recurrent pelvic pain in endometriosis. These clinical observations form the basis of the estrogen threshold theory. Normal menstrual cycle, estradiol (E_2) concentration range 50 ~ 300pg / ml, in this range to stimulate the growth and function of EM lesions. After bilateral ovariectomy, E 2 concentration dropped to 5 ~ 15pg / ml, such a low level of ectopic endometrial lesions atrophy, but the low hormone state to accelerate bone loss and vasomotor symptoms.