Leiomyoma-related bleeding: A classic hypothesis updated for the molecular era

Elizabeth A Stewart, Romana A. Nowak

Research output: Contribution to journalArticle

155 Citations (Scopus)

Abstract

Leiomyomas are an important cause of menorrhagia and other forms of abnormal uterine bleeding. The pathogenesis of this process is largely unknown, however. A classic theory, first suggested by Sampson's work in 1912, states that local dysregulation of the vascular structures in the uterus is responsible for this abnormal bleeding. Recent work demonstrates dysregulation of a number of growth factors in the myomatous uterus. As many of these factors regulate the process of angiogenesis or have other effects on vascular structures, we hypothesize that this dysregulation of growth factors or their receptors provides the molecular mechanism underlying these vascular abnormalities. In turn, these abnormal vessels lead women with leiomyomas to experience menorrhagia. Factors that may prove to be important in this process include basic fibroblast growth factor, vascular endothelial growth factor, heparin-binding epidermal growth factor, platelet-derived growth factor, transforming growth factor-β, parathyroid hormone-related protein and prolactin. Current treatment regimens for women with leiomyoma-related bleeding depend on manipulation of the steroid hormone environment. By better understanding the pathogenesis of this disease process, therapies directed against growth factor abnormalities may result in better treatment with less harmful side-effects.

Original languageEnglish (US)
Pages (from-to)295-306
Number of pages12
JournalHuman Reproduction Update
Volume2
Issue number4
StatePublished - Jul 1996
Externally publishedYes

Fingerprint

Leiomyoma
Blood Vessels
Menorrhagia
Intercellular Signaling Peptides and Proteins
Hemorrhage
Uterus
Parathyroid Hormone-Related Protein
Uterine Hemorrhage
Platelet-Derived Growth Factor
Transforming Growth Factors
Fibroblast Growth Factor 2
Epidermal Growth Factor
Prolactin
Vascular Endothelial Growth Factor A
Heparin
Therapeutics
Steroids
Hormones

Keywords

  • Angiogenesis
  • Basic fibroblast growth factor
  • Leiomyoma
  • Menorrhagia
  • Uterus

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Reproductive Medicine

Cite this

Leiomyoma-related bleeding : A classic hypothesis updated for the molecular era. / Stewart, Elizabeth A; Nowak, Romana A.

In: Human Reproduction Update, Vol. 2, No. 4, 07.1996, p. 295-306.

Research output: Contribution to journalArticle

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