During Women’s Health Month, attention turns to the many advances in knowledge about women’s health as well as the gaps that remain in understanding many conditions. The NICHD was founded with a specific focus on women’s health as a way of understanding “the unsolved health problems of children and of mother-infant relationships.” Today, the Institute has one of the broadest and largest NIH research portfolios on women’s health topics, ranging from understanding and treating fertility disorders to preventing mother-to-child transmission of HIV. In addition, the NICHD studies all aspects of pregnancy, from implantation to delivery and beyond.
The Institute’s research includes not only biomedical research, but also behavioral research, such as studies to understand women’s contraceptive behaviors. In this NICHD Spotlight, we highlight just a few of the Institute’s activities related to women’s health, but not specifically those related to pregnancy.
Understanding and Treating Uterine Fibroids
Uterine fibroids, also called Uterine Leiomyoma, are the most common non-cancerous tumors in women of childbearing age. Fibroids are made of muscle cells and other tissues that grow in and around the wall of the uterus, or womb. Fibroids are one of the leading causes of hysterectomy in the United States.
Still, researchers don’t know what causes the tumors, nor is there a reliable long-term medical treatment for fibroid symptoms, which include pain, heavy menstrual periods, anemia (low blood iron), and fatigue, that works in all women who have the tumors. Research also shows that African American women and those who are obese are at greater risk for uterine fibroids, but the reason for the increased risk is not known.
Although answers remain mysterious, researchers have made progress in learning more about the disease. For example, researchers know that fibroids grow in response to progesterone, a hormone made by the ovaries. If researchers can lower the amount or action of progesterone in the body, they believe that they may be able to shrink the fibroids and relieve many of the symptoms. Defining and testing this therapy is the focus of an NICHD clinical trial, which will hopefully provide answers to this important research question.
Another clinical trial is led by Dr. Alicia Armstrong, in the Section on Reproductive Medicine within the NICHD’s Division of Intramural Research Program on Reproductive and Adult Endocrinology. Dr. Armstrong and her colleagues are seeking female volunteers between the ages of 35 and 42, who have symptoms of fibroids, who want to maintain their fertility, and who are candidates for a fibroid treatment called myomectomy—a procedure that removes only the fibroids and leaves the healthy areas of the uterus in place—to take part in this study. Those interested should call the NIH Patient Recruitment and Public Liaison Office at 1-800-411-1222 (TTY: 1-866-411-1010).
Beyond Infertility: Polycystic Ovary Syndrome (PCOS)
PCOS is the most common cause of anovulatory (related to the absence of ovulation) infertility in the United States. It affects between 5 percent and 10 percent of women of childbearing age. The symptoms of PCOS generally include infertility, menstrual problems, excess body or facial hair (called hirsutism), oily skin and acne, and fluid-filled cysts on the ovaries.
The NICHD has been a leader in conducting and supporting PCOS research for decades—in fact, the Institute sponsored the 1990 meeting at which the first set of diagnostic features for PCOS were defined. Since then, the Institute has supported a significant amount of research—much of it through the Reproductive Medicine Network and the Specialized Cooperative Centers Program in Reproduction and Infertility Research, supported by the Reproductive Sciences Branch. This research has enabled scientists to learn a great deal about PCOS, from possible mechanisms of the disease to effective treatments for anovulatory infertility. An important finding of this research is the knowledge that women with PCOS are at higher risk for certain health conditions, beyond just the symptoms of PCOS, than women who do not have the condition. These associated conditions can include metabolic syndrome, diabetes, cardiovascular disease, and obstructive sleep apnea.
To help educate women, their families, and their health care providers about PCOS and its associated disorders, the NICHD is publishing a new booklet about PCOS— Beyond Infertility: Polycystic Ovary Syndrome (PCOS) —available free through the NICHD Information Resource Center. The Institute will also distribute the booklet to members of the American College of Obstetricians and Gynecologists and The Endocrine Society to increase knowledge about the features of PCOS among health care providers who may care for women with the disorder.
In addition, the NICHD is supporting a number of clinical trials related to PCOS, including some related to improving pregnancy outcomes for women with PCOS and treatments for its associated disorders. The NICHD has also issued a number of news releases about PCOS research.
Partnerships and Collaborations to Advance Women’s Health
In addition to its own broad mission in women’s health research, the NICHD also collaborates with other NIH Institutes, government agencies, and non-governmental organizations to help improve women’s health and health research in the United States and around the world. Some examples of these activities include the following:
- Clinical Trials to Prevent Postnatal Breastmilk HIV Transmission—The NICHD has a large portfolio of research on HIV/AIDS in women and on preventing mother-to-child transmission of HIV. Through these efforts and in collaboration with other Institutes and organizations, the rate of mother-to-child transmission in the United States has dropped from 27 percent to less than 2 percent. Since 2003, the NICHD’s Pediatric, Adolescent, and Maternal AIDS Branch (PAMAB) has been collaborating with the Centers for Disease Control and Prevention (CDC) to support clinical trials to assess interventions for reducing HIV transmission through breastmilk and to improve infant survival in resource-limited countries with high HIV incidence. The PAMAB/CDC collaboration has supported two trials—the Kesho Bora Study and the PEPI-Malawi Study. For more information about these and other activities related to HIV/AIDS and women’s health, you can view the Pediatric, Adolescent, and Maternal AIDS Branch Report to the NACHHD Council, June 2007.
- Vulvodynia Awareness Campaign—The NICHD is a major contributor to this effort, led by the NIH Office of Research on Women’s Health (ORWH) in collaboration with the National Institute of Neurological Disorders and Stroke, the NIH Pain Consortium, and other organizations. Researchers estimate that between 16 percent and 18 percent of women experience symptoms consistent with vulvodynia, a term used to describe chronic pain or discomfort of the vulva.
- Global Network for Women’s and Children’s Health Research—This Network, started by the NICHD in partnership with the Bill and Melinda Gates Foundation, is committed to preventing maternal and infant deaths and illnesses worldwide, improving the health of mothers and infants, building local capacity for doing research, and strengthening scientific and community partnerships. Several Global Network clinical trials are underway and many projects have already been completed. Visit the Global Network page of the NICHD Web site for more information.
- Pelvic Floor Disorders Research Network—As many as one-third of adult women in the United States may suffer from one or more pelvic floor disorders—problems related to the muscles in and around the pelvis. Led by the NICHD Contraception and Reproductive Health Branch, in collaboration with the National Institute of Diabetes and Digestive and Kidney Diseases, the NIH ORWH, and other NICHD components, and in consultation with the American Urogynecologic Society, the Pelvic Floor Disorders Network conducts research to understand the prevalence of, risk factors for, genetics of, and other topics related to pelvic floor disorders. The Network’s clinical trials on pelvic floor disorders are conducted through its seven clinical research sites.
More Women’s Health Information
For more topics related to women's health, please visit the A-Z Topics page.
Originally Posted: May 23, 2008
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