Our research specifically examines local mechanisms within the womb-lining (endometrium) involved in menstruation, abnormal uterine bleeding, and implantation and early pregnancy loss. Both menstruation and implantation display features common to inflammatory events. Menstruation is a physiological event of repeated "tissue injury and repair". We study the cascade of events that occur in cells of the endometrium and that lead to its shedding. These events are triggered by withdrawal of the hormone, progesterone (P). This occurs at the end of each monthly cycle prior to a period. As a consequence of P-withdrawal, substances that are mediators of inflammation and populations of immune cells are increased in the endometrium. We are interested in the complex dialogue between circulating steroid hormones and the many different cell types, including immune cells that constitute the endometrium.
We also study factors that switch on production of molecules involved in blood vessel growth and repair in the endometrium; both necessary events to prepare for the next menstrual cycle. If we can understand how the womb heals itself without scarring as women go through their menstrual cycles we hope we will contribute valuable information relevant to inflammation and scarring throughout the body. If these events are disturbed then abnormal menstrual bleeding may be the result. We are therefore studying endometrial samples collected from women attending with menstrual complaints including women with fibroids. We hope that information about the molecular and cellular pathways involved in menstruation will help identify new targets for treatment, especially if these treatments could be delivered directly to the uterus.