Estrogen receptor β: the guardian of the endometrium

Hapangama, D.K.; Kamal, A.M.; Bulmer, J.N.

doi:10.1093/humupd/dmu053

Cited by 145Estrogen and related hormone effectsEndometrial and Cervical Cancer TreatmentsEffects and risks of endocrine disrupting chemicals

Estrogen receptor β: the guardian of the endometrium

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Hapangama, D.K., Kamal, A.M., Bulmer, J.N.·2015·Human Reproduction Update

DOI 10.1093/humupd/dmu053

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Abstract

BACKGROUND: The endometrium is the primary target organ for the 'female' sex steroid hormone estrogen, which exerts effects in the endometrium via two main classical estrogen receptor (ER) isoforms, ERα and ERβ. The main function of the endometrium, embryo implantation, appears unperturbed in ERβ knockout mice, which has led researchers to disregard other potentially important functional roles that ERβ may have in endometrium. This review focuses on ERβ in the human endometrium and its protective role from the undesired effects of ERα. METHODS: We conducted a systematic search using PubMed and Ovid for publications between January 1996 and February 2014. All studies that examined ERβ expression or function in non-pregnant endometrium or cells derived from the endometrium were considered, including human and animal studies. RESULTS: Studies of the basic function of ERβ isoforms in restraining ERα-mediated cell-specific trophic/mitotic responses to estrogen in other tissues has allowed appreciation of the important potential role of ERβ in the regulation of cell fate in the human endometrium. Our current understanding of ERβ expression and function in endometrium is, however, incomplete. ERβ is dynamically expressed in healthy premenstrual endometrium, persists in post-menopausal atrophic endometrium and may play an important role in endometrial disease. All endometrial cell types express ERβ and aberrations in ERβ expression have been reported in almost all benign and malignant endometrial proliferative disease. CONCLUSIONS: The collective evidence suggests that ERβ has an important role in normal endometrial function and also in most, if not all, benign and malignant endometrial diseases. However, the conduct of studies of endometrial ERβ expression needs to be standardized: agreement is needed regarding the most appropriate control tissue for endometrial cancer studies as well as development of standardized methods for the quantification of ERβ immunohistochemical data, similar to those scoring systems employed for other hormonally regulated tissues such as breast cancer, since these data may have direct clinical implications in guiding therapy.

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Normal endometrium responds to E2 by activating ERα and ERβ, with ERβ serving as a guardian that suppresses ERα to bridle ERα-mediated mitogenic response to E2.
“Even though there is no local E2 production, the normal endometrium responds to E2 by activating ERα and ERβ with ERβ serving as a ‘guardian’, suppressing ERα to bridle ERα-mediated mitogenic response to E2 (Hapangama et al., 2015).”
From Progressively diminished estrogen signaling concordant with increased fibrosis in ectopic endometrium (2025) · cites this paper as Hapangama et al., 2015
The paper says E2 acts through ERα and ERβ in the endometrium (Human endometrium as an estrogen-receptive organ, p. 2) and that ERβ can oppose ERα activity (Estrogen receptors, p. 3). But it *postulates*, rather than establishes, that ERβ restricts E2’s mitogenic action in healthy endometrium (ERβ expression across the menstrual cycle, p. 8). The citing sentence presents that proposed protective mechanism as fact. (LLM, conf=0.87)
Experimental — accuracy not yet measured
The observed ERα downregulation but ERβ upregulation may be attributable to increased local E2 concentration that activates ERβ, which in turn suppresses ERα.
“This may be attributable to increased local E2 concentration that activates ERβ, which, in turn, suppresses ERα, accounting for the observed ERα downregulation but ERβ upregulation (Hapangama et al., 2015).”
From Progressively diminished estrogen signaling concordant with increased fibrosis in ectopic endometrium (2025) · cites this paper as Hapangama et al., 2015
The Estrogen receptors section (p. 3) says E2 can induce ERβ expression and that ERβ can inhibit ERα activity, potentially through increased ERα degradation. The Endometriosis and adenomyosis section (p. 10) also describes ERβ overexpression alongside low ERα expression and reports that ERβ overexpression can reduce ERα levels. The paper does not establish the proposed increase in local E2 concentration as the cause of that expression pattern. (LLM, conf=0.86)
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Androgens, oestrogens and endometrium: a fine balance between perfection and pathology
Gibson, D. A., Simitsidellis, I., Collins, F., & Saunders, P. T. K. (2020) · Journal of Endocrinology · doi:10.1530/joe-20-0106 · Cited by 76 · see citing works
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Authors: Hapangama, D. K., Kamal, A. M., & Bulmer, J. N.
Affiliations: University of Liverpool (GB)
Newcastle University (GB)
ORCID: Kamal, A.M.
Venue: Human Reproduction Update
Publisher: Oxford University Press (OUP)
Published: 2014-10-10
Volume: 21
Issue: 2
Pages: 174-193
ISSN: 1355-4786 (ISSN-L)
1460-2369
DOI: 10.1093/humupd/dmu053
OpenAlex: W1974712212
Cited by: 145
References: 206
Citations by year: 2026: 5 · 2025: 17 · 2024: 8 · 2023: 20 · 2022: 15 · 2021: 10 · 2020: 18 · 2019: 16 · 2018: 8 · 2017: 5 · 2016: 11 · 2015: 11 · 2013: 1
FWCI: 1.19
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Human Reproduction Update (publishedVersion)
PubMed (publishedVersion)
HighWire Press Open Archive (submittedVersion)
Newcastle University ePrints (Newcastle Univesity)
Funders: Wellbeing of Women (RG1487, RG1073)
Biotechnology and Biological Sciences Research Council (BB/E016790/1)
Topics: Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Estrogen and related hormone effects
Health Sciences › Medicine › Obstetrics and Gynecology › Endometrial and Cervical Cancer Treatments
Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Effects and risks of endocrine disrupting chemicals
Keywords: estrogen receptor beta, endometrium, estrogen receptor alpha, endometrial cancer, endometrial disease, estrogen signaling
MeSH terms: Animals, Endometrium, Estrogens, Female, Humans, Models, Biological, Primates, Uterine Diseases, Mice, Knockout, Estrogen Receptor beta

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Estrogen receptor β: the guardian of the endometrium

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