This program supports basic, translational and clinical studies into the epidemiology, natural history, etiology, prevention, diagnosis, and treatment of benign gynecologic disorders. Examples of research topic areas covered by this program include uterine fibroids, endometriosis, adenomyosis, ovarian cysts, and menstrual disorders. An emerging focus is in the delineation of the genomic and epigenomic profiles associated with these disorders in order to gain better insight into the genetic, cellular, and environmental interactions underlying their pathogenesis. Emphasis is placed on the development of new treatments including surgical, radiologic, pharmacologic, hormonal, nutritional, and behavioral approaches, as well as study of the safety and efficacy of both existing and novel treatments.
Other aspects of reproductive health covered in this program include understanding the impact of gynecologic disorders on female sexual function and the role of the vaginal microbiome on gynecologic health and disease. Also of importance to this program is evaluation of disparities in the incidence and treatment responses of these gynecologic conditions across various socioeconomic, racial, and ethnic populations.
Uterine leiomyomata (fibroids) represent the most common benign gynecologic tumor in women and are associated with an array of detrimental health effects including abnormal uterine bleeding, pelvic pain, infertility, miscarriage, and preterm labor. They represent a significant reproductive health disparity, with African American women diagnosed two to three times more frequently than Caucasian women. The mechanisms that initiate fibroid growth are poorly understood, resulting in limited therapeutic approaches. Additional investigation into the pathogenesis of fibroid development and growth is aimed at development of effective and safe conservative treatments.
Endometriosis affects about 10% of women of reproductive age and contributes significantly to the development of pelvic adhesions, infertility, ectopic pregnancy, and chronic pelvic pain. Additional investigation is required regarding the underlying etiology, pathophysiology, and mechanisms leading to the morbidity associated with this condition. Increased knowledge about the key processes that contribute to the initiation and establishment of endometriosis will advance development of effective diagnostic approaches and facilitate development of improved therapeutic options.
Abnormal menstrual bleeding impacts quality of life due to irregular or excessive bleeding and can herald underlying gynecologic pathology such as the presence of endometrial polyps, uterine fibroids, or anovulatory conditions. This program supports studies which investigate menstrual disorders across all reproductive ages with a focus on etiology, prevention, treatment, genetic predisposition, racial/ethnic differences, and environmental influences. Particular emphasis is placed on promoting research in periods of reproductive transition (i.e., puberty/adolescence and the perimenopause). Interests include normal and abnormal sexual maturation/puberty as well as the early diagnosis and treatment of anovulation due to hypothalamic-pituitary disorders, polycystic ovarian syndrome (PCOS), functional ovarian cysts, or structural abnormalities of the reproductive tract outside of impact on fertility.