Endometrial hormone receptors in women with dysfunctional uterine bleeding

Objective The objective was to study the estrogen receptor (ER) and progesterone receptor (PR) expression in endometrium of women with dysfunctional uterine bleeding (DUB) as compared to women with normal menstrual cycles.

In this study, 30 patients and 20 controls were selected. Transvaginal ultrasound and endometrial sampling for histology and ER and PR estimation immunohistochemically was carried out for all the subjects. Student’s t-test and linear correlation was used for statistical analysis. Their response to treatment was assessed by clinical follow-up.

Endometrial thickness and ER and PR levels in DUB patients were significantly higher. In cases showing hyperplastic endometria, ER and PR levels were higher than patients with normal histology. In contrast to hyperplastic tissue, steroid receptor levels decrease in hyperplastic tissue containing atypia.

Altered endometrial morphology and increased receptor levels in DUB patients suggest that unopposed estrogen effect could have an important role in the pathogenesis of DUB. Cases of DUB, which showed atypical hyperplasia, may have a down-regulation of these receptors and could be a precursor lesion to carcinoma and thus do not respond to medical therapy by hormones. Similar content being viewed by others

Bancroft JD, Stevens A (1996) Theory and practice of histological techniques, 4th edn. Churchill Livingstone Bergeron C, Ferenczy A, Shyamala G (1988) Distribution of estrogen receptors in various cell types of normal, hyperplastic and neoplastic human endometrial tissues. Lab Invest 59:862–869 Chwalisz K, Brenner RM, Fuhrmann UU, Hess-Stumpp H, Elger W (2000) Antiproliferative effects of progesterone antagonists and progesterone receptor modulators on endometrium. Steroids 65:741–751 Critchley HOD, Abberton KM, Taylor NH, Healy DL, Rogers PAW (1994) Endometrial sex steroid receptor expression in women with menorrhagia. Br J Obstet Gynecol 101:428–434 Davis JTA, Schlaff WD (1995) Dysfunctional uterine bleeding, polyps and fibroids. In: Diamond MP, DeCherney AH (ed) Infertility and reproductive medicine, vol 6, no 2. Saunders, Philadelphia, pp 401–415 Gasier AF, Wang H, Davie JE, Kelly RW, Critchley HO (2002) Administration of anti-progesterone upregulates estrogen receptors in endometrium of women using Norplant: a pilot study. Fertil Steril 77:366–372 Gleeson N, Jordan M, Sheppard B, Bonnar J (1993) Clinical variation in endometrial estrogen and progesterone receptors in women with normal menstruation and dysfunctional uterine bleeding. Eur J Obstet Gynecol Reprod Biol 48:207–214 Gorodeski IG, Geier A, Siegal A, Beery R, Lunenfeld B, Langzam J, Bahari CM (1984) In vitro induction of progesterone receptors in normal postmenopausal endometrium—an evidence of inhibitory control of RP synthesis. Maturitas 6:123 Haynes PJ, Anderson ABM, Turnbull AC (1979) Patterns of menstrual blood loss in menorrhagia. Res Clin Forum 1:73–78 Leake RE (1981) Steroid receptors in normal and cancer tissue. In: Stoll BA (ed) Hormonal management of endocrine related cancer. Lloyd Luke, London pp 3–12 Lessey BA, Killam AP, Metzger DA, Haney AF, Greene GL, Mccarty KS (1988) Immunohistochemical analysis of human estrogen and progesterone receptors throughout the menstrual cycle. J Clin Endocrinol Metabl 67:334–340 Levy C, Robel P, Gautray JP, Brux JD, Verma U, Descomps B, Baulieu EE (1980) Estradiol and progesterone receptors in human endometrium: normal and abnormal menstrual cycles and early pregnancy. Am J Obstet Gynecol 136:646–651 Masuzawa H, Badokhon NH, Nakayama K, Konishi I, Nikaido T, Fuji S (1994) Failure of down regulation of estrogen receptors and progesterone receptors after medroxyprogesterone acetate administration for endometrial hyperplasia. Cancer 74:2321–2328 Nyholm HCJ, Nielsen AL, Lyndrup J, Norup P, Thorpe SM (1992) Biochemical and immunohistochemical estrogen and progesterone receptors in adenomatous hyperplasia and endometrial carcinoma: correlation with stage and other clinicopathologic features. Am J Obstet Gynecol 167:1334–1342 Olive DL (2002) Role of progesterone antagonists and new selective progesterone receptor modulators in reproductive health. Obstet Gynecol Surv 57 [Suppl 4]:555–563 Padubidri VG, Daftary SN (1999) Disorders of menstruation. In: Shaw’s textbook of gynaecology, 12th edn, Churchill Livingstone, New Delhi, pp 214–239 Press MF, Nousek-Goeble NA, King WJ, Herbst AL, Greene GL (1984) Immunohistochemical assessment of estrogen receptor distribution in human endometrium throughout the menstrual cycle. Lab Invest 51:495–503 Rees MCP, Dunhill MS, Anderson ABM et al (1984) Quantitative uterine histology during menstrual cycle in relation to measured menstrual blood loss. Br J Obstet Gynecol 91:662–666 Spitz I M (2003) Progesterone receptors and progesterone receptor modulators: an overview. Steroids 68:981–983 Spitz IM, Chwalisz K (2000) Progesterone receptor modulators and progesterone antagonists in women’s health. Steroids 65:807–815 Author information Authors and Affiliations Corresponding author Rights and permissions About this article Cite this article Chakraborty, S., Khurana, N., Sharma, J.B. et al. Endometrial hormone receptors in women with dysfunctional uterine bleeding. Arch Gynecol Obstet 272, 17–22 (2005). https://doi.org/10.1007/s00404-004-0639-5 Received: Accepted: Published: Issue date: DOI: https://doi.org/10.1007/s00404-004-0639-5