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

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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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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: Critchley, Hilary O. D.
Brenner, Robert M.
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 › Endocrinology › 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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The endocrinology of menstruation – a role for the immune system

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