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Characterization of subendometrial myometrial contractions throughout the menstrual cycle in normal fertile women
Open accessAbstract
The objective was to study the characteristics of ultrasonographically detected subendometrial myometrial contractions. The contractions were evaluated by 328 ultrasound scans throughout the menstrual cycle. Reproducibility of these findings were studied in consecutive cycles. Eighteen healthy ovulatory volunteers with proven fertility were evaluated for at least one complete menstrual cycle in the follicular, periovulatory, and luteal phases. Multiple cycles were studied in 10 volunteers. The results showed that the contractions increase in frequency, amplitude, and percentage toward the fundus throughout the follicular and periovulatory phases. The pattern is essentially reversed in the luteal phase. There is reproducibility of these patterns from cycle to cycle. We conclude that there is a definite identifiable pattern of subendometrial myometrial contractility that varies with the phases of the normal menstrual cycle and recurs in a similar fashion from cycle to cycle.
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“It became evident that the non-pregnant uterus is constantly active throughout the reproductive period of life and thereby, like other mechanically active organs of the body such as the skeletal and the cardiovascular systems, respectively, rather inevitably subjected to mechanical strain.”
From The pathophysiology of endometriosis and adenomyosis, tissue injury and repair (2009) · cites this paper as [13]
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“Ultrasonography of the human uterus has revealed cranially directed waves of uterine smooth muscle contractions that increase in intensity through the follicular phase until the time of ovulation [18, 19].”
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“However, during menstruation, contraction waves appear to be directed toward the cervix (44, 45).”
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“Unfortunately, these methods are unfeasible for routine use during IVF procedures and checkups because they are invasive, expensive, or employing ionizing radiations.(4,34) Visualization of uterine contractility by transvaginal ultrasonography has been recently more extensively used due to the availability and noninva…”
MethodCharacteristics of uterine peristalsis in spontaneous and induced cycles
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“Subendometrial myometrium exerts wave-like activity throughout the menstrual cycle (3, 13), and the movement is believed to support embryo and sperm transfer.”
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“Although uterine peristalsis is reported to be the least during luteal phase, the T2* value of the junctional zone was still significantly lower than outer myometrium (14,15,17).”
BackgroundJunctional Zone on Magnetic Resonance Imaging: Continuous Changes on Ultrafast Images
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“0 (CD0) 87% – – 13% – Early luteal phase(2,6) – – 77% – – 23% –”
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“The directed transport of spermatozoa and a high fundal implantation rate of embryo result, at least in part, from endometrial movements (1, 2, 4, 5).”
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Maggio, C. D., Jennings, S. R., Robichaux, J. L., Stapor, P. C., & Hyman, J. M. (2011) · Bulletin of Mathematical Biology · doi:10.1007/s11538-011-9681-1 · Cited by 19
“For example, in the nonpregnant uterus, the size and frequency of subendometrial contractions increases during the folicular phase, peaks at ovulation, and then decreases during menstruation (Lyons et al. 1991).”
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Kido, A., & Togashi, K. (2016) · Reproductive Medicine and Biology · doi:10.1007/s12522-016-0235-y · Cited by 19
“menstrual cycle phases under the influence of hormonal variations [20, 21].”
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“Transient contraction of the myometrium as a physiological condition may also simulate a focal or diffuse adenomyosis [8, 10, 11].”
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“The direction of contractions or peristalsis is also reversed in the luteal phase [43].”
BackgroundOptimized approach to cine MRI of uterine peristalsis
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Creatine metabolism in the uterus: potential implications for reproductive biology
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The Role of Oestradiol in the Uterine Peristalsis in the Perfused Swine Uterus
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“In humans the oestradiol peak during the menstrual cycle occurs when an effective transport mechanism towards the fundus uteri and the Fallopian tube is needed for sperm transport (Lyons et al. 1991; Fukuda and Fukuda 1994).”
BackgroundBioengineering Studies of the Embryo Transfer Procedure
Eytan, O., Elad, D., & Jaffa, A. J. (2007) · Annals of the New York Academy of Sciences · doi:10.1196/annals.1389.028 · Cited by 15
Uterine junctional zone thickness in infertile women evaluated by MRI
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“The major function of the JZ during the reproductive period of women is directing sperm transport into the tube ipsilateral to the dominant follicle, which is provided by JZ uterine peristalsis (5-7).”
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Investigation of uterine peristalsis diurnal variation
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“Such movements were demonstrated by transvaginal ultrasound (TVUS) a number of years ago [1,2] and, more recently, by cine-mode MR imaging [4–6].”
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“Furthermore, it has also been shown in normal fertile women that sub-endometrial peristalsis of the junctional zone myometrium progressively increases during menstrual cycle reaching a peak at time of ovulation with the pattern changing from predominantly ante-grade (fundo-cervical) in the menstrual and proliferative…”
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“5 waves per min, respectively, in early follicular, periovulatory and luteal phases (2).”
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“The frequency of uterine contractions increases at the follicular phase of the menstrual cycle and this is decreased at the luteal phase (Bulletti et al., 1993; Lyons et al., 1991).”
BackgroundEffect of prostaglandin and antiprostaglandin on midcycle myometrial contractions
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“For women with fertility problems due to endometriosis, the peristaltic waves can be arrhythmic and irregular during the late follicular phase (Lyons et al., 1991; Leyendecker et al., 1996).”
BackgroundEffect of oral contraceptives and intrauterine devices on midcycle myometrial contractions
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BackgroundFeatures of the hypointense solid lesions in the female pelvis on T2‐weighted MRI
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“In contrast, peristalsis is reduced during the luteal phase probably to facilitate implantation of the embryo (2,5).”
BackgroundIn the mouse, prostaglandin D2 signalling protects the endometrium against adenomyosis
Philibert, P., Déjardin, S., Pirot, N., Pruvost, A., Nguyen, A. L., Bernex, F., Poulat, F., & Boizet‐Bonhoure, B. (2021) · Molecular Human Reproduction · doi:10.1093/molehr/gaab029 · Cited by 11
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Uterine relaxation by sacral surface electrical stimulation on the day of embryo transfer
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Fujimoto, K., Nakai, A., Okada, T., Ikeuchi, T., Satogami, N., Daido, S., Yakami, M., & Togashi, K. (2010) · Journal of Magnetic Resonance Imaging · doi:10.1002/jmri.22252 · Cited by 8
“Previous reports have shown that strong myometrial contraction is seen at menstrual phase, whereas uterine peristalsis is observed most frequently during a periovulatory phase (20).”
BackgroundInfluence of mycotoxins on spontaneous contraction in myometrial strips of prepubertal lamb
Giammarino, A., Manera, M., Robbe, D., Perugini, M., Minervini, F., & Amorena, M. (2007) · Research in Veterinary Science · doi:10.1016/j.rvsc.2007.07.002 · Cited by 8
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Mock embryo transfer does not affect uterine contractility
Torre, A., Scheffer, J. B., Schonäuer, L. M., Frydman, N., & Fanchin, R. R. F. (2009) · Fertility and Sterility · doi:10.1016/j.fertnstert.2008.10.054 · Cited by 8
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Uterine peristalsis of adenomyosis patients on cine magnetic resonance imaging
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Influence of vibrating wall on microswimmer migration in a channel
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A Review and Reconsideration of Nonneoplastic Myometrial Pathology
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“Most important has been the realization that the uterus undergoes regular subclinical inner wall contractions during menstrual cycles (53-55).”
BackgroundCoitus and menstruation in perimenopausal women
Cutler, W. B., Friedmann, E., & McCoy, N. L. (1996) · Journal of Psychosomatic Obstetrics & Gynecology · doi:10.3109/01674829609025676 · Cited by 7
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Stewart, J. K., Myers, E. R., Petrozza, J. C., Kaufman, C. S., Golzarian, J., Kohi, M. P., Chiang, A., Carlos, R. C., Spies, J. B., Abi‐Jaoudeh, N., et al. (2024) · Journal of Vascular and Interventional Radiology · doi:10.1016/j.jvir.2024.05.014 · Cited by 6
Abu-Musa, A. A., Usta, I. M., Nassar, A. H., Hajami, F., & Hannoun, A. B. (2007) · Fertility and Sterility · doi:10.1016/j.fertnstert.2007.05.043 · Cited by 6
Paavonen, J. A. (2005) · Medicine · doi:10.1383/medc.2005.33.10.43 · Cited by 6
Irregular or absent periods—what can an ultrasound scan tell you?
Khalid, A. (2004) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1016/j.bpobgyn.2003.09.002 · Cited by 6
Kido, A., Fujimoto, K., Matsubara, N., Kataoka, M., Konishi, I., & Togashi, K. (2015) · Magnetic Resonance in Medical Sciences · doi:10.2463/mrms.mp.2015-0084 · Cited by 6
Siegelman, E. S. (2005) · Elsevier eBooks · doi:10.1016/b978-0-7216-3740-2.50012-1 · Cited by 6
Postablation neuroma of the myometrium—a report of 5 cases
Cramer, S. F., & Heller, D. S. (2017) · Human Pathology · doi:10.1016/j.humpath.2017.08.013 · Cited by 6
“This approach to analyzing hysterectomies for benign disease is based on a modern understanding of the uterus as a complex muscular organ with great histologic heterogeneity [8-10]; baseline myometrial tone [15,17]; contractions during menstrual cycles [18-21]; ability to contract both downward and upward towards eith…”
BackgroundA Pregnancy Prediction System based on Uterine Peristalsis from Ultrasonic Images
Mori, K., Kitaya, K., Ishikawa, T., & Hata, Y. (2021) · Intelligent Automation & Soft Computing · doi:10.32604/iasc.2021.01010 · Cited by 5
An optimised repetition time (TR) for cine imaging of uterine peristalsis on 3 T MRI
Liu, S., Zhang, Q., Yin, C., Chen, W., Chan, Q., He, J., & Zhu, B. (2018) · Clinical Radiology · doi:10.1016/j.crad.2018.03.012 · Cited by 5
Alberola-Rubio, J., Diaz‐Martinez, A., Mira‐Tomas, J. M., Faubel, P. A., Sanz, S. C., Cortés, G. C., de Arriba-Garcia, M., Aparicio, J. L., & Garcia‐Casado, J. (2025) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2025.03.042 · Cited by 5
van Gestel, I., IJland, M. M., Willekes, C., Evers, J. L. H., & Hoogland, H. J. (2008) · Fertility and Sterility · doi:10.1016/j.fertnstert.2007.09.054 · Cited by 5
“In the second half of the cycle, the uterus becomes more quiescent (2, 9).”
BackgroundBafor, E. E., Nwogu, J. K., Elvis‐Offiah, U. B., Amaechina, F. C., Ofeimun, J. O., Ayinde, B. A., Omoruyi, O., Viegelmann, C., & Edrada‐Ebel, R. (2018) · Journal of Medicinal Plants for Economic Development · doi:10.4102/jomped.v2i1.33 · Cited by 5
“It has been shown that an increase in frequency of uterine contractions occurs during the follicular phase followed by a decrease during the luteal phase of the menstrual cycle (Bulletti et al. 1993; Lyons et al. 1991).”
BackgroundTimor‐Tritsch, I. E. (2007) · Elsevier eBooks · doi:10.1016/b978-0-443-06630-6.50016-0 · Cited by 5
Metadata
- Authors
- Lyons, E. A., Taylor, P. J., Zheng, X. H., Ballard, G., Levi, C. S., & Kredentser, J. V.
- Affiliations
- Health Sciences Centre (CA)
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 1991-04
- Volume
- 55
- Issue
- 4
- Pages
- 771-774
- ISSN
- 0015-0282 (ISSN-L)
- OpenAlex
- W119618046
- Cited by
- 272
- References
- 5
- Citations by year
- 2026: 3 · 2025: 11 · 2024: 8 · 2023: 5 · 2022: 6 · 2021: 10 · 2020: 9 · 2019: 4 · 2018: 8 · 2017: 17 · 2016: 7 · 2015: 13 · 2014: 6 · 2013: 4 · 2012: 6
- FWCI
- 0.68
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Menstrual Health and Disorders
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Keywords
- uterine contractility, menstrual cycle phases, follicular phase, periovulatory period, luteal phase, uterine fundus, reproducibility, ovulatory women
- MeSH terms
- Adult, Female, Fertility, Humans, Menstrual Cycle, Reference Values, Ultrasonography, Uterine Contraction, Uterus
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