The endometrium and gynaecological symptoms

The sixty-five publications, which are included in this thesis, report a continuous research interest and activity over more than 25 years in the unique and still mysterious process of menstruation, its related symptoms and the various roles of the endometrium in these processes. These research activities are largely a continuation of interests developed during work for my MD thesis. None of the publications submitted for this thesis formed a part of my MD or other thesis. The publications cover three main areas of research: heavy menstrual bleeding; breakthrough bleeding in women using long-acting progestogen-only methods of contraception; and pelvic pain and its relationship to pelvic innervation and local cellular immunology in endometriosis. I have summarised the work presented in the 65 publications in the Introduction, below, with reference to each publication as part of a developing theme, rather than on a chronological basis. Heavy menstrual bleeding (HMB): This section includes 25 papers, beginning with reports of studies aimed at addressing the objective measurement of menstrual blood loss and total fluid loss in different clinical situations where HMB is a problem. These are followed by a series ... (continues)