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The mechanisms through which progestins exert their therapeutic effects are the anti-estrogenic effects, anti-vasculogenic action, induction of apoptotic cascade in endometriotic cells, suppression of inflammatory pathways (as production of metalloproteinases), cell proliferation suppression, and also anti-neurogenic effects with inhibition of nerve growth within endometriotic lesions [59, 63, 64]

this effect may be additive with the prolonged vasoconstriction caused by ergot alkaloids