GHDB supports basic, translational and clinical research programs related to gynecologic health throughout the reproductive lifespan, beginning at puberty and extending through the early menopause. The branch also supports research training and career development programs for investigators interested in women's reproductive health. Research in the GHDB portfolio may be funded through grants, cooperative agreements, or contracts.
As a newly established branch, efforts focus on sponsoring research in selected gynecologic areas that have either been overlooked or underfunded, including socioeconomic, racial and ethnic disparities in reproductive health outcomes. The branch portfolio includes studies on menstrual disorders, uterine fibroids, endometriosis, ovarian cysts and polycystic ovary syndrome, pelvic floor disorders, as well as studies of the mechanisms underlying chronic pelvic pain, vulvodynia, and dysmenorrhea. Obstetric fistula and female genital cutting are also of interest as they apply to both international and immigrant communities. Emerging emphasis is placed on the role of genomics and epigenomics in elucidating etiology and providing novel approaches for treatment options in an array of gynecologic disorders.
Research directed at gynecologic disorders will provide high quality evidence to direct the development of novel methods for prevention, diagnosis, and treatment of gynecologic disorders with the overall goal of improving women's reproductive health and quality of life.
Longitudinal Gynecologic Studies
Gap: The natural history of fibroids, endometriosis, menstrual irregularities, dysmenorrhea, and other gynecologic disorders has been poorly studied, particularly in the early reproductive lifespan.
Priority: Identify ways to participate in ongoing or soon-to-be initiated longitudinal studies to include relevant questions with an emphasis on inclusion of adolescents to better understand risk factors and pivot points for preventing these disorders.
Mechanisms of Gynecologic Pain Syndromes
Gap: Current understanding regarding the prevalence, biological mechanisms, psychological variables, and clinical risk factors responsible for the development of gynecologic pain syndromes is limited. New advances are needed in every area of chronic pain research, from molecular sciences to the behavioral and social sciences.
Priority: Support multidisciplinary investigations to delineate the genetic, cellular, molecular, environmental, and psychosocial factors underlying the etiology of chronic gynecologic pain syndromes, including mechanisms both in common with and distinct from other chronic pain conditions.
Gap: Current pharmacologic treatments for abnormal bleeding, fibroids, and endometriosis act primarily via modulation of the steroid hormonal milieu, thereby exerting broad effects across multiple steroid-responsive tissues. There is a need for medical therapies that specifically target abnormal gynecologic cell types.
Priority: Encourage the development of novel, non-hormonal pharmacologic treatments for gynecologic disorders.
Non-Invasive Diagnostic and Assessment Tools
Gap: Emerging imaging techniques and insights into the biology of gynecologic tissues provide opportunities to develop innovative approaches for the early detection and clinical monitoring of these diseases. These tests will ideally be non-invasive, rapid, inexpensive, and widely available as well as highly sensitive and specific.
Priority: Promote the development and/or application of novel imaging methods and biomarkers to gynecologic disorders.
'–Omics' in Gynecologic Disorders
Gap: Development of powerful '–omics' approaches have been significantly undersupported in the gynecologic research field despite their potential to provide substantial insights into the pathophysiology of specific disease states, as well as the ability to develop new, patient-specific treatments.
Priority: Encourage multidisciplinary investigation of the genome, epigenome, and/or transcriptome as they impact development, progression, and/or treatment response in gynecologic conditions. Examination of the interaction between environmental factors and genetic and/or epigenetic markers are of particular interest.
Stem/Progenitor Cells in Gynecologic Health and Disease
Gap: Emerging data suggest a role for stem cells in normal and abnormal menstrual bleeding, in the pathophysiology of specific gynecologic disease states, and as targets for the treatment of gynecologic disorders, including regenerative therapy in pelvic floor disorders.
Priority: Support projects investigating the role of endogenous stem cells in the etiology and pathophysiology of gynecologic disorders, including those that utilize or develop stem-cell based therapeutics.
Gap: To date, advances in relevant basic science fields have not been routinely incorporated into gynecologic research studies.
Priority: Promote research based on findings from diverse fields to advance basic and mechanistic understanding of gynecologic health and disease. These fields include (but are not limited to) engineering, neurobiology, skeletal and smooth muscle biology, vascular biology, immunology, and relevant aspects of cell biology such as studies of extracellular matrix and cell-cell interactions. The development of new transdisciplinary collaborations is encouraged.
- Gynecologic Diseases and Disorders: Supports basic, translational, and clinical studies into the epidemiology, natural history, etiology, prevention, diagnosis, and treatment of benign gynecologic disorders
- Pelvic Floor Disorders: Focuses on the accumulation and analysis of good quality evidence to inform directed methods for the prevention, diagnosis, and treatment of pelvic floor disorders
- Vulvodynia and Chronic Pelvic Pain: Supports clinical, translational, and basic research on gynecologic pain conditions including chronic pelvic pain, painful menses (dysmenorrhea), and vulvodynia
- Pelvic Floor Disorders Network (PFDN): Encourages collaborative research on pelvic floor disorders and aims to improve patient care
- Women's Reproductive Health Research (WRHR) Career Development Program: Provides the opportunity for obstetrician/gynecologists who recently completed postgraduate clinical training to further their education and experience in basic, translational, and clinical research
- None at this time
- Lisa Halvorson, Branch Chief
Main Research Areas: Endometriosis/adenomyosis; training: women's health (includes the Women's Reproductive Health Research Program)
- Donna Mazloomdoost, Medical Officer
Main Research Areas: Pelvic floor disorders, including urinary incontinence; obstetric fistula/female genital mutilation
- Candace Tingen, Program Officer
Main Research Areas: Chronic pelvic pain/dysmenorrhea/vulvodynia; uterine fibroids/leiomyoma; menstrual disorders