Menstrual physiology: implications for endometrial pathology and beyond
Top Cited Papers
Open Access
- 7 August 2015
- journal article
- review article
- Published by Oxford University Press (OUP) in Human Reproduction Update
- Vol. 21 (6), 748-761
- https://doi.org/10.1093/humupd/dmv038
Abstract
Each month the endometrium becomes inflamed, and the luminal portion is shed during menstruation. The subsequent repair is remarkable, allowing implantation to occur if fertilization takes place. Aberrations in menstrual physiology can lead to common gynaecological conditions, such as heavy or prolonged bleeding. Increased knowledge of the processes involved in menstrual physiology may also have translational benefits at other tissue sites. Pubmed and Cochrane databases were searched for all original and review articles published in English until April 2015. Search terms included ‘endometrium’, ‘menstruation’, ‘endometrial repair’, ‘endometrial regeneration’ ‘angiogenesis’, ‘inflammation’ and ‘heavy menstrual bleeding’ or ‘menorrhagia’. Menstruation occurs naturally in very few species. Human menstruation is thought to occur as a consequence of preimplantation decidualization, conferring embryo selectivity and the ability to adapt to optimize function. We highlight how current and future study of endometrial inflammation, vascular changes and repair/regeneration will allow us to identify new therapeutic targets for common gynaecological disorders. In addition, we describe how increased knowledge of this endometrial physiology will have many translational applications at other tissue sites. We highlight the clinical applications of what we know, the key questions that remain and the scientific and medical possibilities for the future. The study of menstruation, in both normal and abnormal scenarios, is essential for the production of novel, acceptable medical treatments for common gynaecological complaints. Furthermore, collaboration and communication with specialists in other fields could significantly advance the therapeutic potential of this dynamic tissue.Keywords
Funding Information
- Medical Research Council (G0000066, G0500047, G0600048, MR/J003611/1)
- Wellcome Trust (083908/Z/07/Z, 100646/Z/12/Z)
This publication has 148 references indexed in Scilit:
- The evolution of menstruation: A new model for genetic assimilationBioEssays, 2011
- Derivation of Insulin Producing Cells From Human Endometrial Stromal Stem Cells and Use in the Treatment of Murine DiabetesMolecular Therapy, 2011
- The Regulation of Vascular Endothelial Growth Factor by Hypoxia and Prostaglandin F2αduring Human Endometrial RepairJournal of Clinical Endocrinology & Metabolism, 2011
- Alternative Activation of Macrophages: Mechanism and FunctionsImmunity, 2010
- Isolation and Culture of Epithelial Progenitors and Mesenchymal Stem Cells from Human Endometrium1Biology of Reproduction, 2009
- Inhibition of 11β–hydroxysteroid dehydrogenase type II selectively blocks the tumor COX-2 pathway and suppresses colon carcinogenesis in mice and humansJCI Insight, 2009
- VEGF blockade inhibits angiogenesis and reepithelialization of endometriumThe FASEB Journal, 2008
- Menstrual Blood-derived Cells Confer Human Dystrophin Expression in the Murine Model of Duchenne Muscular Dystrophy via Cell Fusion and Myogenic TransdifferentiationMolecular Biology of the Cell, 2007
- Cyclooxygenase enzyme expression and E series prostaglandin receptor signalling are enhanced in heavy menstruationHuman Reproduction, 2007
- Resolution of inflammation: the beginning programs the endNature Immunology, 2005