Matrix Metalloproteinases, Leukocytes and Menstruation

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Menstrual bleeding problems are a common cause of pain and discomfort for women and often are satisfactorily treated only by hysterectomy. Despite this, little is known about the processes causing menstruation. Recently, we and others have demonstrated a role for a family of biological catalysts (enzymes) which break down the structure of the tissue lining the uterus (the endometrium) and are thought to cause menstrual bleeding. However, the mechanisms regulating their production during the normal menstrual cycle is still largely unknown. Cells which come initially from the blood (leukocytes, particularly neutrophils and eosinophils) dramatically increase in numbers immediately prior to menstruation and these along with other cells, known as mast cells, start to produce a number of factors which we postulate are important for regulation of the enzymes. These cells, are also present in high numbers in endometrium of women with menstrual bleeding problems. This study will demonstrate that both the enzymes, and the leukocytes play a critical role in menstruation and will determine how the leukocytes in the endometrium are regulated. The studies have important implications for understanding and treating menstrual bleeding disorders.