PTGS2 and endometriosis: Moreover, Cox-2 is overexpressed in endometriotic epithelial and stromal cells and its principal metabolic product, prostaglandin E2, a hallmark of most inflammatory lesions, is a biologically active signaling lipid mediator known as an eicosanoid, which regulates many pathophysiological processes in the development and exacerbation of endometriosis, including cell proliferation, anti-apoptosis, migration, invasion, immune escape, angiogenesis, pelvic pain, dysmenorrhea, and infertility [40].