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Background Endometriosis is an estrogen-dependent disease, and aromatase is the key enzyme for estrogen biosynthesis.Elevated levels of aromatase mRNA have been found in ovarian endometriomas.There is a strong association between prostaglandin (PG) E2 levels and the development and severity of endometriosis, and PGE2 seems to be the most potent known stimulator of P450arom in endometriotic stromal cells.