Promoting Gynecologic, Andrologic, and Reproductive Health
Highlighted Programs and Activities
Women's Reproductive Health Research (WRHR) Career Development Program
NICHD’s longstanding WRHR Career Development Program is a nationwide group of mentored institutional career development programs that train junior faculty who have recently completed postgraduate clinical training in obstetrics and gynecology and are committed to an independent research career in women's reproductive health. The program's goal is to continue to build the national capacity of outstanding junior clinician-investigators who will strengthen the field of obstetrics and gynecology and contribute to the improvement of women’s health. Learn more: RFA-HD-25-005.
Selected Recent Advances
- Repurposed drug shows promise against endometriosis-related pain in animal model (PMID: 38510116)
Researchers used a computer algorithm to evaluate nearly 1,300 existing compounds for their ability to reverse gene expression related to endometriosis. Using publicly available data from people with endometriosis, scientists identified 299 candidate compounds with 7 considered top candidates. These drugs included commonly used treatments for the disease, such as aspirin, as well as those not yet studied for this purpose. The researchers chose to conduct additional studies to evaluate fenoprofen, a nonsteroidal anti-inflammatory drug, because it returned the highest gene expression reversal score. Although fenoprofen belongs to a drug class that is one of the first-line treatments for endometriosis, analysis of electronic medical records from five health care institutions showed that the drug had been prescribed for less than 1% of patients with endometriosis or related conditions, although it is often prescribed for arthritis. The researchers tested fenoprofen in a rodent model of the disease, observing that it successfully alleviated vaginal hyperalgesia, a surrogate marker for endometriosis-related pain. If future studies in people confirm these findings, the researchers suggest that fenoprofen could be prescribed more frequently to treat endometriosis pain. - Potential treatment approach for uterine fibroids shows promise in early mouse study (PMID: 38072367)
In previous studies, uterine fibroids were characterized by overexpression of an enzyme called tryptophan 2,3 dioxygenase (TDO2). To follow up on that discovery, researchers in this study used a mouse model to test whether inhibiting TDO2 would affect fibroid size and development. Their results indicated that treatment with a compound called 680C91 resulted in changes to the mice that were consistent with reduced fibroid size and decreased expression of inflammatory genes. - Vaginal film is a safe and effective contraceptive in a preliminary study (PMID: 36870409)
Many women cannot use hormonal contraceptives, or desire to only use contraceptives when needed (on-demand). However, current nonhormonal, on-demand, female-controlled contraceptives (e.g., female condoms and diaphragms) have had generally low uptake worldwide. Moreover, these methods require spermicide use, and frequent spermicide use increases mucosal inflammation, alters the vaginal microbiome, and may increase the risk of contracting HIV. To meet the growing need for more accessible and acceptable contraceptives, researchers developed ZB-06, a vaginal film containing a human contraceptive antibody that inactivates sperm. In this first-in-woman, phase 1, proof-of-concept study, researchers aimed to assess the potential contraceptive activity of the ZB-06 film in a small number of women. The results indicated that a single dose of the ZB-06 film applied before intercourse was safe for both female participants and their male partners, and all female participants had significantly fewer progressively motile sperm in their ovulatory cervical mucous after intercourse, compared with the no-product-use baseline. One month after film use, there were no residual anti-sperm antibodies, which indicates that the contraceptive is reversible. These data indicate that ZB-06 is a viable contraceptive candidate warranting further development and testing. - Effectiveness and safety of a pessary for management of pelvic organ prolapse (PMID: 38761837)
In their lifetime, millions of American women seek care for pelvic organ prolapse, a condition that occurs when one or more of the organs in the pelvis move down from their normal position and bulge into the vagina. A pessary, a nonsurgical treatment option, is a removable device, typically made of silicone, that is inserted by the individual or a health care provider into the vagina to support the pelvic organs. While pessaries are an effective treatment for prolapse, they can cause discomfort during insertion and removal, which may lead to discontinued use. This led researchers to study individuals’ experience with a new pessary design that is collapsible with a loop removal feature to improve the comfort and ease of removal and reinsertion. The scientists recruited 62 individuals using a standard pessary to treat their pelvic organ prolapse and surveyed them about their symptoms and experience. The individuals were then provided the novel collapsible pessary for 3 months. Compared to individuals’ current pessary, the new pessary was equally effective in providing prolapse support and relieving pelvic floor symptoms. Although there was a higher incidence of vaginal discharge and spotting with the new pessary, most participants found it less painful to insert and remove. This suggests that the novel collapsible pessary may provide individuals with more comfort and independence in managing their pessary, though additional research is needed to determine if side effects can be reduced.
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