Menstruation and Menstrual Problems: Research Activities and Scientific Advances

• Institute Activities and Advances
• Other Activities and Advances

Institute Activities and Advances

The NICHD conducts and supports research to learn more about menstrual irregularities. The following organizational units address issues related to menstruation and the causes and effects of menstrual irregularities.

• The Division of Epidemiology Statistics and Prevention Research (DESPR) is interested in statistical methodology, comparative etiologies, and the health endpoints needed to identify mechanisms, at-risk groups, and interventions. Some of these activities include:
• Developing various approaches to modeling menstrual cycle function. The menstrual cycle is a complex process that involves multiple hormones regulated by feedback mechanisms. To describe the factors associated with menstrual cycle function and inform women's health research, the DESPR is developing statistical models to answer questions like:
• What is the "typical" menstrual cycle pattern in a population of women?
• What is the effect of a subject-specific covariate on a typical menstrual cycle?
• How does the variation in menstrual cycle function differ between women and across consecutive cycles on the same woman?
• What is the inter-relationship between multiple hormones across the menstrual cycle?
• Gaining a better understanding of the intricate relationship between hormone levels and oxidative stress during the menstrual cycle (estrogen, progesterone, luteinizing hormone, etc.). Data from the BioCycle Study are helping researchers examine the intracycle variation of oxidative stress; the relation between hormone levels and oxidative stress during the menstrual cycle in premenopausal women; and the influence of external factors (such as cigarette smoking, alcohol consumption, and exercise) on oxidative stress and hormone levels.
• Various components of the Division of Intramural Research study aspects of menstruation and menstrual irregularities. For example:
• The Section on Reproductive Endocrinology works on endometrial physiology and endometriosis pathologies. The section has published studies on the endometrium, localization of lesions in endometriosis, characterizing receptors, and the use of raloxifene as a treatment for endometriosis. This section also published a landmark article on the hypothalamic-pituitary-adrenal (HPA) axis during pregnancy.
• The Unit on Reproductive and Regenerative Medicine conducts research on disorders that affect reproduction. The section is interested in endometrial stem cells and disorders that affect the endometrium. These disorders can result in scarring of the uterine cavity, abnormal bleeding, endometriosis, infertility due to implantation failures, and recurrent pregnancy loss.
• The Unit on Reproductive Endocrinology and Infertility is studying the relationship between the BRX gene complex and uterine fibroid generation. The laboratory also is studying gene regulation and growth factors involved in uterine fibroid development.
• The Unit on Genetics of Puberty and Reproduction conducts research on the genetic basis of sexual maturation. In particular, researchers are examining the ways in which mutations in genes linked to pubertal development can lead to disorders of puberty and reproduction.

• Components of the Division of Extramural Research also support studies on normal menstruation and conditions related to menstrual irregularities. Some of this work includes:

• Fertility and Infertility (FI) Branch projects include:
• A comprehensive, patient-based outcome measure for heavy menstrual bleeding
• Estrogen and progesterone regulation of human endometrial cell proliferation
• GPR30-mediated estrogen action on ovarian physiology and ovarian cancer
• Mechanism of action of prohibition in ovarian cell function
• Pediatric Growth and Nutrition Branch projects include:
• The neuroendocrine regulation of the reproductive axis during puberty and development to understand the critical role of hormones and neural circuits in essential reproductive and developmental processes. Also, to gain insight into the mechanisms responsible for reproductive disorders and diseases that may be associated with menstrual irregularities, such as idiopathic hypogonadotropic hypogonadism, nutritional infertility, oligomenorrhea,  and precocious or delayed puberty.
• The relationship of amenorrhea to bone loss in adolescent and young adult athletes by examining the fat-mediated modulation of reproductive and endocrine function in young athletes.
• The Gynecologic Health and Disease Branch (GHDB) studies normal menstruation as well as diseases that cause menstrual irregularities, such as uterine fibroids, endometriosis, polycystic ovary syndrome, and primary ovarian insufficiency, to name a few.

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Other Activities and Advances

The NICHD is also active in other areas of research related to understanding causes and effects of menstrual irregularities. Some of these activities include:

• Through the FI Branch, the NICHD supports the following research networks and centers programs that contribute to understanding menstrual irregularities within the context of fertility and infertility:

• Reproductive Medicine Network (RMN)
• Reproductive Scientist Development Program (RSDP)
• Specialized Cooperative Centers Program in Reproduction and Infertility Research (SCCPIR)

• The GHDB supports the following project that aims to understand the conditions and diseases that may lead to menstrual irregularities and how to treat those conditions:
• The Women's Reproductive Health Research (WRHR) Career Development Program allows obstetricians/gynecologists who have recently completed clinical training to enhance their education and experience with basic, translational, and clinical research on women’s health topics, including normal menstruation and menstrual irregularities.

Between 2010 and 2012, the Institute was also involved in the following meetings related to menstruation and menstrual irregularities:

12/3/2012 Evidence-Based Methodology Workshop on Polycystic Ovary Syndrome (PCOS)

10/25/2012 Ovarian Reserve: Regulation & Implications for Women's Health

1/24/2011 NICHD Director's Lecture Series: New Frontiers in Endometriosis

11/22/2010 Advances in Uterine Leiomyoma Research: 3rd NIH International Congress