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Cited by 203Menstrual Health and DisordersReproductive System and PregnancyEstrogen and related hormone effects

The endocrinology of menstruation – a role for the immune system

Critchley, Hilary O. D., Kelly, Rodney W., Brenner, Robert M., Baird, David T.·2001·Clinical Endocrinology
DOI 10.1046/j.1365-2265.2001.01432.x
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Abstract

The human endometrium displays characteristic features, both structural and functional, across the menstrual cycle. It is the sex steroid hormones, oestrogen and progesterone, that drive the endometrium through the different phases of the cycle. Oestrogen and progesterone act sequentially to regulate cellular concentrations of their respective receptors, this interaction initiates gene transcription. Thereafter a cascade of local events prepares the endometrium for implantation, but in the absence of pregnancy, progesterone withdrawal leads to menstruation and cyclic repair. Withdrawal of progesterone from an oestrogen-progesterone primed endometrium is the initiating event for the cascade of molecular and cellular interactions that result in menstruation. Progesterone withdrawal first affects cells with progesterone receptors. Early events in the menstrual process are vasoconstriction and cytokine up-regulation. The activation of lytic mechanisms is a later event and involves cells that may lack progesterone receptors, for example, uterine leucocytes and epithelial cells. Hence progesterone withdrawal results in a local increase of inflammatory mediators and the enzymes responsible for tissue breakdown. The total complex of local factors implicated in normal menstrual and aberrant menstrual bleeding are yet to be fully defined.

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  • These mediators and enzymes facilitate leukocyte influx into tissues.

    “These mediators and enzymes, in turn, facilitate influx of leukocytes into tissues”

    From Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications (2011) · cites this paper as Critchley et al., 2001

  • With progesterone withdrawal in the premenstrual phase, stromal, endothelial, and immune cells change and induce local mediators including chemokines, cytokines, cell regulators, and enzymes for prostaglandin synthesis and degradation.

    “With withdrawal of progesterone during the premenstrual phase, stroma, endothelium and immune cells undergo changes, inducing local mediators such as chemokines, cytokines, cell regulators and enzymes responsible for prostaglandin synthesis and degradation.”

    From Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications (2011) · cites this paper as Critchley et al., 2001

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Authors
Critchley, H. O. D., Kelly, R. W., Brenner, R. M., & Baird, D. T.
Affiliations
  • University of Edinburgh (GB)
  • MRC Centre for Reproductive Health (GB)
Corresponding author
Critchley, Hilary O. D.
ORCID
Venue
Clinical Endocrinology
Publisher
Wiley
Published
2001-12
Volume
55
Issue
6
Pages
701-710
ISSN
  • 0300-0664 (ISSN-L)
  • 1365-2265
DOI
10.1046/j.1365-2265.2001.01432.x
OpenAlex
W2106927311
Cited by
203
References
89
Citations by year
2026: 6 · 2025: 6 · 2024: 4 · 2023: 4 · 2022: 13 · 2021: 6 · 2020: 8 · 2019: 8 · 2018: 6 · 2017: 4 · 2016: 3 · 2015: 10 · 2014: 6 · 2013: 11 · 2012: 14
FWCI
1.16
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 42 d)
Locations
  • Clinical Endocrinology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Menstrual Health and Disorders
  • Life Sciences › Immunology and Microbiology › Immunology › Reproductive System and Pregnancy
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Estrogen and related hormone effects
Keywords
menstruation, endometrium, progesterone withdrawal, estrogen, progesterone receptor, immune system, inflammation, cytokines, vasoconstriction, endometrial repair, menstrual bleeding, implantation
MeSH terms
Adult, Hypoxia, Endometrium, Estradiol, Female, Humans, Immune System, Lymphokines, Menstruation, Progesterone, Endothelial Growth Factors, Receptors, Growth Factor, Inflammation Mediators, Matrix Metalloproteinases, Receptor Protein-Tyrosine Kinases, Receptors, Vascular Endothelial Growth Factor, Vascular Endothelial Growth Factors, Vascular Endothelial Growth Factor A

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