Menstruation: science and society

American Journal of Obstetrics and Gynecology, Journal Year: 2020, Volume and Issue: 223(5), P. 624 - 664

Published: July 21, 2020

Women's health concerns are generally underrepresented in basic and translational research, but reproductive particular has been hampered by a lack of understanding uterine menstrual physiology. Menstrual is an integral part overall because between menarche menopause, most women menstruate. Yet for tens millions around the world, menstruation regularly often catastrophically disrupts their physical, mental, social well-being. Enhancing our underlying phenomena involved menstruation, abnormal bleeding, other menstruation-related disorders will move us closer to goal personalized care. Furthermore, deeper mechanistic menstruation-a fast, scarless healing process healthy individuals-will likely yield insights into myriad diseases involving regulation vascular function locally systemically. We also recognize that many now delay pregnancy there increasing desire fertility preservation. In September 2018, Gynecologic Health Disease Branch Eunice Kennedy Shriver National Institute Child Human Development convened 2-day meeting, "Menstruation: Science Society" with aim "identify gaps opportunities science raise awareness need more research this field." Experts fields ranging from evolutionary role endometrial biology (including omic analysis endometrium, stem cells tissue engineering microbiome, bleeding fibroids) medicine (imaging sampling modalities, patient-focused including smart technologies or applications mobile platforms) societal challenges literacy dissemination frameworks across different economic cultural landscapes shared current state-of-the-art future vision, incorporating patient voice at launch meeting. Here, we provide enhanced meeting report extensive up-to-date (as submission) context, capturing spectrum how processes commence response progesterone withdrawal, through tissue-resident circulating progenitor monthly regeneration-and knowledge on dysregulation leads such as adenomyosis, endometriosis, fibroids-to clinical diagnostics, treatment, education. conclude overview global agenda concerning specifically hygiene, gaining momentum, investment addressing barriers facing girls schools low- middle-income countries recent "menstrual equity" "period poverty" movements spreading high-income countries.

Language: Английский

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Bacterial vaginosis and its association with infertility, endometritis, and pelvic inflammatory disease

American Journal of Obstetrics and Gynecology, Journal Year: 2020, Volume and Issue: 224(3), P. 251 - 257

Published: Oct. 19, 2020

Bacterial vaginosis, pelvic inflammatory disease, and endometritis are infections of the genital tract that can lead to many adverse health outcomes, including infertility. vaginosis is characterized by a lower prevalence lactobacilli higher anaerobic bacteria, Gardnerella vaginalis, Megasphaera spp., Atopobium vaginae. Endometritis disease caused ascension pathogenic bacteria uterus, although mechanisms which they do so unclear. chronic endometritis, have been linked infertility in retrospective prospective trials. Similarly, causes bacterial endometritis-related likely multifactorial stem from inflammation, immune targeting sperm antigens, presence toxins, increased risk sexually transmitted infections. Diagnosis treatment before attempting conception may be important components preconceptional care for symptomatic women improve outcomes natural assisted reproduction.

Language: Английский

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The role of gut and genital microbiota and the estrobolome in endometriosis, infertility and chronic pelvic pain

Human Reproduction Update, Journal Year: 2021, Volume and Issue: 28(1), P. 92 - 131

Published: Sept. 30, 2021

Endometriosis is a chronic, burdensome condition that historically understudied. Consequently, there lack of understanding the etiology disease and its associated symptoms, including infertility chronic pelvic pain (CPP). development influenced by estrogen metabolism inflammation, which are modulated several factors microbiome estrobolome (the collection genes encoding estrogen-metabolizing enzymes in gut microbiome). Therefore, increasing interest role microbiota endometriosis etiology.To date, no cure for treatment options often ineffective. This manuscript will review potential relationship between endometriosis, CPP highlight available data on relation to related symptoms. The overarching goal this inform future research lead deeper possible diagnostic modalities treatments. impact regulation estrobolome, as well inflammation other endometriosis-promoting mechanisms within genital tract, be reviewed. methodological limitations microbiome-related studies critically assessed provide improved guidelines clinical studies.PubMed databases were searched using following keywords: AND microbiome, IVF (in-vitro fertilization) infertility. Clinical preclinical animal trials eligible review, or included. All manuscripts published 2002-2021.In total, 28 6 included review. In both human studies, bacteria enriched groups, although was clear consensus specific compositions with endometriosis. However, bacterial vaginosis-associated Lactobacillus depletion cervicovaginal majority (23/28) studies. Interpretation endometrial limited owing variety factors, discussed addition, metadata outlining antibiotic usage, age, race/ethnicity, menopausal status timing sample diagnosis not consistently reported. Animal (6/6) support bidirectional onset progression.There evidence dysbiotic multiple gynecologic conditions, mounting supporting an association These microbiomes likely play gut-brain axis, further supports putative spectrum symptoms CPP. Collectively, highlights demand more rigorous transparent methodology controls, consistency across field, inclusion key demographic characteristics comparison participants. Rigorous study designs allow better disorders female reproductive tract.

Language: Английский

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New Opportunities for Endometrial Health by Modifying Uterine Microbial Composition: Present or Future?

Biomolecules, Journal Year: 2020, Volume and Issue: 10(4), P. 593 - 593

Published: April 11, 2020

Current knowledge suggests that the uterus harbours its own microbiota, where microbes could influence uterine functions in health and disease; however, core microbial composition host-microbial relationships remain to be fully elucidated. Different studies are indicating, based on next-generation sequencing techniques, dysbiosis associated with several gynaecological disorders, such as endometriosis, chronic endometritis, dysfunctional menstrual bleeding, endometrial cancer, infertility. Treatments using antibiotics probiotics and/or prebiotics for being applied. Nevertheless there is no unified protocol assessing optimal treatment established dysbiosis. With this review we outline (mostly bacteria) identified microbiome studies, current treatments offered bacterial clinical setting, future possibilities pro- transplants modifying composition.

Language: Английский

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A review of the pathophysiology of recurrent implantation failure

Fertility and Sterility, Journal Year: 2021, Volume and Issue: 116(6), P. 1436 - 1448

Published: Oct. 20, 2021

Language: Английский

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Translocation of vaginal microbiota is involved in impairment and protection of uterine health

Nature Communications, Journal Year: 2021, Volume and Issue: 12(1)

Published: July 7, 2021

Abstract The vaginal and uterine microbiota play important roles in the health of female reproductive system. However, interactions among microbes these two niches their effects on remain unclear. Here we profile microbial samples 145 women, combine with deep mining public data animal experiments to characterize translocation tract its role modulating health. Synchronous variation increasing convergence microbiome advancing age are shown. We also find that transplanting certain strains bacteria into vagina rats induces or reduces endometritis-like symptoms, verify damaging protective endometrium. This study clarifies interdependent relationship bacterial microecology endometrial health, which will undoubtedly increase our understanding

Language: Английский

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The Endometrial Microbiome and Its Impact on Human Conception

International Journal of Molecular Sciences, Journal Year: 2022, Volume and Issue: 23(1), P. 485 - 485

Published: Jan. 1, 2022

Changes in the female genital tract microbiome are consistently correlated to gynecological and obstetrical pathologies, dysbiosis can impact reproductive outcomes during fertility treatment. Nonetheless, a consensus regarding physiological core inside uterine cavity has not been reached due myriad of study limitations, such as sample size experimental design variations, influence endometrial bacterial communities on human reproduction remains debated. Understanding healthy microbiota how changes its composition affect would potentially allow personalized treatment through management assisted therapies, ultimately leading improvement clinical outcomes. Here, we review current knowledge it relates conception.

Language: Английский

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Regulation of Inflammation Pathways and Inflammasome by Sex Steroid Hormones in Endometriosis

Frontiers in Endocrinology, Journal Year: 2020, Volume and Issue: 10

Published: Jan. 29, 2020

Endometriosis is a gynecological disorder characterized by the growth of endometrial tissue (glands and stroma) outside uterus, mainly in peritoneal cavity, ovaries, intestines. This condition shows estrogen dependency progesterone resistance, it has been associated with chronic inflammation, severe pain, infertility, which negatively affect quality life reproductive-age women. The molecular mechanisms involved pathogenesis endometriosis are not completely understood, however, inflammation plays key role pathophysiology disease, altering function immune cells (macrophages, T cells, natural killer ) increasing levels pro-inflammatory mediators endometrium, blood. These alterations, inhibit apoptotic pathways promote adhesion proliferation endometriotic as well angiogenesis neurogenesis lesions. It demonstrated that hormonal alterations related to inflammatory unbalance this disease. Particularly, steroid hormones (mainly estradiol) expression release factors. In turn, excessive observed contributes resistance high sensitivity modulating sex receptors aromatase activity. addition, dysregulation inflammasome pathway, mediated an alteration cellular responses hormones, participates disease progression through preventing cell death, promoting adhesion, invasion, Furthermore, endometriosis-associated due response mounted alters their receptivity impairing biochemical decidualization. purpose review present overview current research about clarify probable

Language: Английский

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Recent Insights on the Maternal Microbiota: Impact on Pregnancy Outcomes

Frontiers in Immunology, Journal Year: 2020, Volume and Issue: 11

Published: Oct. 23, 2020

Hormonal changes during and after pregnancy are linked with modifications in the maternal microbiota. In our manuscript, we describe importance of microbiota examine whether microbial composition at different body sites may have an association complications. We also analyze likely interactions between immune system. Gastrointestinal (Gut) Microbiota. During pregnancy, undergoes profound changes, leading to increase lactic acid-producing bacteria a reduction butyrate-producing bacteria. The meaning such still remains be clarified. Additionally, various studies indicated possible involvement gut autoimmune life-long diseases. Vaginal human vagina has its own microbiota; vaginal seem related number Recent shown reduced Lactobacilli, increased bacterial diversity, low levels β-defensin-2 patients preterm birth (PTB). contrast, early healthy pregnancies characterized by diversity numbers communities dominated Lactobacillus. These observations suggest that cultures, show absence Lactobacillus polymicrobial colonization, risk factors for PTB. Endometrial Endometrium is not sterile site: it only been recent years resident endometrial defined. Questions remain however around what main components their impact on reproductive tract, terms both fertility outcomes. A classification based patterns would help develop microbiota-based diagnosis, personalized therapies prevention obstetrical complications treatments through nutritional, microbial, or pharmaceutical interventions.

Language: Английский

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The impact of the female genital tract microbiome in women health and reproduction: a review

Journal of Assisted Reproduction and Genetics, Journal Year: 2021, Volume and Issue: 38(10), P. 2519 - 2541

Published: June 10, 2021

Language: Английский

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