Gynecologic Health and Disease Branch (GHDB)

Tissue under MicroscopeOverview/Mission

GHDB aims to improve women’s reproductive health by guiding and supporting gynecologic research and career development programs with the vision of a future in which women lead lives free of the effects of gynecologic disorders. The branch portfolio includes studies of healthy functioning endometrium and menstruation, as well as gynecologic disorders including endometriosis, adenomyosis, fibroids, and polycystic ovary syndrome. In addition to abnormal vaginal bleeding and pain throughout the reproductive lifespan, these disorders may affect fertility potential, delay pregnancy, and contribute to maternal morbidity and adverse pregnancy outcomes.

The branch has an interest in pelvic organ prolapse as well as urinary and fecal incontinence related to pelvic floor dysfunction. Obstetric fistula and female genital cutting, which affect international and U.S. immigrant communities, are also areas of interest.

We are interested in applications that align with the following research priorities. For more information about NICHD’s research themes, cross-cutting topics, and aspirational goals, visit the plan’s Scientific Research Themes and Objectives.

Non-Invasive Diagnostic and Screening Tools

Strategic Plan Theme 2: Promoting Gynecologic, Andrologic, and Reproductive Health
Strategic Plan Cross-Cutting Topics: Disease Prevention, Health Disparities
Strategic Plan Aspirational Goal: Accelerate efforts to definitively diagnose, prevent, and treat endometriosis

Gap: Emerging imaging techniques and insights into the biology of gynecologic tissues provide opportunities for developing innovative approaches to the early detection and clinical monitoring of gynecologic diseases. These tools are likely to play a pivotal role in pursuing natural history studies, better understanding phenotypic variability, reducing the interval between development of symptoms and diagnosis, and determining the safety and efficacy of novel treatments.

Priority: Research that develops and/or applies novel imaging methods and biomarkers to gynecologic disorders, especially endometriosis, adenomyosis, and fibroids. These tests should be non-invasive, rapid, inexpensive, and widely available to medically underserved populations. Of interest are studies that harness the techniques of machine learning and artificial intelligence.

‘Omics in Gynecologic Disorders

Strategic Plan Theme 2: Promoting Gynecologic, Andrologic, and Reproductive Health
Strategic Plan Cross-Cutting Topic: Health Disparities

Gap: 'Omics approaches have the powerful ability to substantially improve our understanding of the etiology and pathophysiology of gynecologic conditions, as well as the ability to develop new, patient-specific treatments.

Priority: Multidisciplinary investigation of the genome, epigenome, and/or transcriptome as they affect healthy endometrium, menstruation, or the development, progression, and/or treatment response in gynecologic conditions. Examination of the interaction between environmental factors and genetic and/or epigenetic markers are of interest, especially for health disparity populations.

Development of Novel Model Systems to Address Health and Disease

Strategic Plan Theme 2: Promoting Gynecologic, Andrologic, and Reproductive Health
Strategic Plan Cross-Cutting Topics: Disease Prevention, Health Disparities

Gap: The study of gynecologic disorders is compromised by a lack of model systems that appropriately recapitulate aspects of the conditions. 

Priority: Innovative in vitro, in vivo, ex vivo, and in silico model systems to study healthy endometrium, menstruation, and gynecologic conditions, including whole animal models, cell lines, organoid culture, and tissue-on-a-chip studies, among other techniques.

Stem/Progenitor Cells and Regenerative Techniques in Gynecologic Health and Disease

Strategic Plan Theme 1: Understanding the Molecular, Cellular, and Structural Basis of Development
Strategic Plan Theme 2: Promoting Gynecologic, Andrologic, and Reproductive Health

Gap: Emerging data suggest a role for stem cells in normal endometrial function, abnormal menstrual bleeding, and the pathophysiology of specific gynecologic disease states, especially endometriosis, adenomyosis, and fibroids. Modulation of stem cell activity shows promise as an effective therapy in other disorders, but it has not been adequately explored for gynecologic conditions.

Priority: Research investigating the role of endogenous stem cells in normal endometrial function and in the etiology and pathophysiology of gynecologic disorders. Of interest is the application of regenerative techniques to the treatment of pelvic floor disorders.

Therapeutics and Devices for Gynecologic Conditions

Strategic Plan Theme 2: Promoting Gynecologic, Andrologic, and Reproductive Health
Strategic Plan Theme 5: Advancing Safe and Effective Therapeutics and Devices for Pregnant and Lactating Women, Children, and People with Disabilities
Strategic Plan Aspirational Goal: Accelerate efforts to definitively diagnose, prevent, and treat endometriosis

Gap: Most treatments for gynecologic disorders are based upon manipulation of the steroid hormone milieu. There is a need for medical and surgical therapies that can specifically target abnormal gynecologic cell types and minimize off-target impact.

Priority: Research that develops safe and effective non-hormonal therapeutics and devices to treat gynecologic disorders such as endometriosis, emphasizing those that preserve fertility and are safe during pregnancy and lactation. 

Mechanisms of Chronic Gynecologic Pain

Strategic Plan Theme 2: Promoting Gynecologic, Andrologic, and Reproductive Health
Strategic Plan Aspirational Goal: Accelerate efforts to definitively diagnose, prevent, and treat endometriosis

Gap: There is limited understanding of the prevalence, biological mechanisms, and clinical risk factors responsible for the development of gynecologic pain syndromes. New advances are needed in the area of gynecologic pain research, particularly considering the known gender differences in the perception of and treatment response to pain.

Priority: Multidisciplinary investigations to delineate the genetic, cellular, and molecular factors underlying the etiology and phenotypic expression of chronic gynecologic pain syndromes, with an emphasis on chronic pelvic pain due to endometriosis and vulvodynia.

Natural History Studies in Gynecology

Strategic Plan Theme 2: Promoting Gynecologic, Andrologic, and Reproductive Health
Strategic Plan Theme 4: Improving Child and Adolescent Health and the Transition to Adulthood
Strategic Plan Cross-Cutting Topics: Disease Prevention, Health Disparities

Gap: The natural history of gynecologic disorders has been poorly studied, particularly across periods of reproductive transition and in broadly representative populations.

Priority: Natural history studies that include relevant questions and appropriate biospecimen collection to better understand the risk factors and pivot points for treating and ultimately preventing these disorders. Of interest is the inclusion of patients across puberty, as well as health disparity populations.

  • Menstruation and Menstrual Disorders: Supports basic, translational, and clinical studies into healthy menstruation and endometrium, as well as the epidemiology, natural history, etiology, prevention, diagnosis, and treatment of menstrual disorders
  • Uterine Fibroids: Supports additional investigation into the pathogenesis of fibroid development and growth aimed at developing effective and safe conservative treatments
  • Endometriosis and Adenomyosis: Focuses on investigation regarding key factors that contribute to the initiation, establishment, and progression of these disorders as well as development of sensitive, less invasive diagnostics to advance development of improved therapeutic options, with a focus on non-hormonal alternatives
  • 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
  • Gynecologic Pain Syndromes: Supports clinical, translational, and basic research on gynecologic pain conditions including chronic pelvic pain, painful menses (dysmenorrhea), vulvodynia, and vestibulodynia
  • Pelvic Floor Disorders Network (PFDN): Encourages collaborative research to inform healthcare providers about diagnosis, care, and treatment of women with pelvic floor disorders
  • 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

  • NIH Helping to End Addiction Long-termSM (HEAL) Initiative: This trans-agency effort, launched in April 2018, focuses on scientific solutions to stem the national opioid crisis, building on established NIH research and networks and including plans to integrate behavioral interventions with medication-assisted treatment for opioid use disorder
  • NIH Pain Consortium: NIH established this consortium, of which NICHD is a member, to enhance pain research and promote collaboration among researchers across the many NIH institutes and centers that have programs and activities addressing pain
  • Trans-NIH Strategic Plan for Women’s Health Research: This 5-year plan highlights a multipronged pathway to advance a vision in which sex and gender influences are integrated into the biomedical research enterprise; every woman receives evidence-based disease prevention and treatment tailored to her own needs, circumstances, and goals; and women in science careers reach their full potential

  • Daniel S. Johnston, Ph.D., Acting Branch Chief
    Main Research Areas: Investigator-initiated research grants; Small Business Innovation Research (SBIR) awards
  • Helena Ahn, Program Officer
    Main Research Areas: Gynecologic pain syndromes, including chronic pelvic pain, dysmenorrhea, and vulvodynia
  • Donna Mazloomdoost, Medical Officer
    Main Research Areas: Pelvic floor disorders, including pelvic organ prolapse, urinary and fecal incontinence; obstetric fistula/female genital mutilation
  • Candace Tingen, Program Officer
    Main Research Areas: Uterine fibroids/leiomyoma; menstrual health and disorders

Highlights

  • Hot Topics and Emerging Trends in Gynecologic Pain Research. View the recording of this virtual meeting, held March 2, 2022, as investigators in the field of gynecologic pain research presented on emerging topics within their fields of expertise and discussed progress, successes, challenges, gaps, and potential future directions within both gynecologic pain research and the wider field of chronic pain research as it relates to gynecologic pain. View the meeting agenda (PDF 161 KB) for more information and links to speaker bios.
  • Physiomimetics and Organoids for Reproductive Health. View the recordings from Day 1 external link and Day 2 external link of this workshop, held September 23-24, 2021, as multidisciplinary experts on physiomimetics, sometimes called “organs-on-a-chip,” and organioids—complex, self-organized 3D-cell culture models that derive from stem/progenitor cells and maintain tissue-like architecture and structure—discuss applications of these technologies for reproductive health research. View the meeting summary (PDF 469 KB) for additional information.
  • Advancing Bioprinting and Regenerative Medicine Solutions for Obstetric, Gynecologic, and Pediatric Applications Workshop. Watch the saved recordings of both days of this workshop, held November 16-17, 2021, as multidisciplinary experts in regenerative medicine research came together for a transdisciplinary discussion on the state-of-the-art of tissue-construct manufacturing using 3D printing of biological, cellular, and tissue-based products (a.k.a., bioprinting) and regenerative medicine in the context of obstetric, gynecologic, and pediatric applications. As a corollary to the workshop, stakeholders can still add ideas to the conversation about priority areas for future research, technology development, and resources in the 3D bioprinting and regenerative medicine fields through the Advancing Bioprinting and Regenerative Medicine Solutions for Obstetric, Gynecologic, and Pediatric Applications IdeaScale campaign external link.
  • Our branch is hiring! Visit our Jobs page to learn more about our GHDB Chief listing.
  • Seminars in Reproductive Medicine. GHDB chief Dr. Lisa Halvorson served as one of the guest editors as well as author of two articles in the November 2020 issue: New Perspectives on Adenomyosis (PMID: 33232984). Adenomyosis, defined as the presence of endometrial tissue within the uterine muscle (myometrium), is associated with pelvic pain, pressure symptoms on the bowel and bladder, abnormal uterine bleeding, infertility, and pregnancy loss. The issue is a useful resource for clinicians and investigators and encourages increased study of this common disorder.
  • Progression of Gynecologic Cancers: Report of the National Cancer Institute (NCI) and NICHD workshop. GHDB and the Division of Cancer Prevention and the Division of Cancer Biology at NCI organized a workshop in April 2019 to explore current insights into the progression of gynecologic cancers from benign conditions. This report highlights the key questions and current challenges that emerged from the working group discussions and presents potential research opportunities that may advance our understanding of the progression of gynecologic benign conditions to cancer. PMID: 32835714
  • Revisiting Menstruation: The Misery, Mystery, and Marvel. GHDB Program Officer Dr. Candace Tingen and Chief Dr. Lisa Halvorson are joined by NICHD Director Dr. Diana W. Bianchi to discuss the need for renewed research about menstruation and an end for stigma surrounding the topic. PMID: 32709301
  • Menstruation: Science and Society. Speakers from the Menstruation: Science and Society meeting convened by GHDB in 2018 provide an enhanced meeting report, capturing the spectrum from when the basic processes of menstruation commence and role of stem and progenitor cells in monthly regeneration to how dysregulation leads to abnormal uterine bleeding and other menstruation-related disorders such as adenomyosis, endometriosis, and fibroids to the clinical challenges in diagnostics, treatment, and patient and societal education. The work concludes with an overview of how the global agenda concerning menstruation, and specifically menstrual health and hygiene, are gaining momentum, ranging from increasing investment in addressing menstruation-related barriers facing girls in schools in low- to middle-income countries to the more recent “menstrual equity” and “period poverty” movements spreading across high-income countries. PMID: 32707266
  • Voices for Pelvic Floor Disorders: Information for New Moms : NICHD grantees at the University of Utah worked with the American Urogynecology Society to create a series of videos and educational information about changes to pelvic floor health that new moms may experience. The information, available in English and Spanish, includes some common changes, possible symptoms, and tips for when to talk with a healthcare provider. The series also offers stories from moms about their experiences and the treatments that worked for them.
  • How to Work Out Your Pelvic Floor (and Why Everyone Should)  : Dr. Donna Mazloomdoost, program director of the NICHD Pelvic Floor Disorders Network, offers insight on the importance of a strong pelvic floor and suggestions for how women can improve their pelvic floor strength.
  • Menstruation as a Diagnostic Tool for Women's Health (Podcast): GHDB program officer Dr. Candace Tingen spoke with NICHD Milestones about the science behind using a woman's menstrual cycle as a diagnostic tool.
  • Gynecologic Health and Disease Research at NICHD: A Scientific Vision (PDF 2 MB)
    Learn more about the scientific portfolio of the branch and its planned research directions.
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