Molecular and Cellular Causes of Abnormal Uterine Bleeding of Endometrial Origin
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⤵ 19 in-corpus citations
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This review discusses molecular and cellular mechanisms of endometrial repair and inflammation, focusing on progesterone withdrawal, vasoactive mediators, and vascular morphology as potential targets for treating heavy menstrual bleeding.
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Abstract
Women today may reasonably anticipate in the order of some 400 menstrual cycles over their reproductive lifespan. The endometrium is thus subject to repeat cycles of shedding and repair and notably healing of the endometrium post menses is "scarless". The local molecular and cellular mechanisms involved in post menstrual resolution of the inflammatory events associated with menstruation and endometrial repair remain to be fully determined. Menstrual complaints are common. It is highly likely that unrestrained local inflammatory events and/ or deficient repair processes within the endometrium contribute to the women's experience of heavy menstrual bleeding (HMB). The management of women with HMB may need to utilize therapeutic approaches that optimize endometrial repair processes, post menses. These approaches may be necessary in addition to current therapies that hitherto have focused on limiting the local inflammation associated with menstruation. Research endeavors thus need to focus upon the molecular and cellular causes of problematic uterine bleeding. Herein the events associated with pre-menstrual progesterone withdrawal, limitation of blood loss, the expression of vasoactive mediators and factors that may modulate vascular morphology are described. Such lines of enquiry and knowledge will be essential if novel targets for treatment of menstrual bleeding complaints, such as HMB, are to be identified.
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Cited by (19)
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- Results of dienogest treatment and its discontinuation in patients with symptomatic adenomyosis: a prospective cohort study 2025
- High prevalence of chronic endometritis in women with nonstructural abnormal uterine bleeding and benefits of antimicrobial treatment on blood loss pattern: A prospective, observational study 2025
- Complementary Chinese Herbal Medicine Treatment is Associated with a Reduction of Surgical Rate in Patients with Dysfunctional Uterine Bleeding: A Propensity-Score Matched Cohort Study 2024
- 'There will be blood'† A proof of concept for the role of haemorrhagic corpora lutea in the pathogenesis of endometriosis 2024
- In Search of an Imaging Classification of Adenomyosis: A Role for Elastography? 2022
- Uterine bleeding: how understanding endometrial physiology underpins menstrual health 2022
- Abnormal uterine bleeding: Terminology, FIGO classification and management 2021
- The endometrial response to modulation of ligand-progesterone receptor pathways is reversible 2021
- Benign Uterine Diseases 2019
- Gynaecology problems in puberty 2019
- Abnormal uterine bleeding 2017
- Differential Gene Expression in Menstrual Endometrium From Women With Self-Reported Heavy Menstrual Bleeding 2016
- Abnormal uterine bleeding 2015
- Cortisol regulates the paracrine action of macrophages by inducing vasoactive gene expression in endometrial cells 2015
- Effect of myrtle fruit syrup on abnormal uterine bleeding: a randomized double-blind, placebo-controlled pilot study 2014
- The importance of the macrophage within the human endometrium 2012
- The FIGO systems for nomenclature and classification of causes of abnormal uterine bleeding in the reproductive years: who needs them? 2012
- Medical treatment of idiopathic heavy menstrual bleeding. What is new? An evidence based approach 2012
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- last seen: 2026-06-10T17:14:06.276822+00:00
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