Promoting Women’s Health

A healthcare provider, who has her back turned to the camera, speaks with a patient who is facing the camera.

Women’s health is a central focus for NICHD. The institute’s research portfolio includes studies to address gynecological issues, pregnancy and pregnancy outcomes, infertility and contraception, and other issues affecting women’s health and wellness.

Uterine fibroids are the most common noncancerous tumors in women. They can cause pain, heavy bleeding, and fertility problems. NICHD-funded researchers surveyed more than 100 women who were scheduled for a hysterectomy to treat their uterine fibroids. They found that exposure to chronic stress in childhood may influence fibroid severity in adulthood. For example, childhood exposure to substance abuse in the household was linked to more severe fibroid symptoms and lower quality of life. A history of childhood sexual abuse was also associated with lower quality of life due to fibroid symptoms. The findings underscore the need to explore how psychosocial factors may contribute to fibroid risk.

The ability to identify women at risk of developing uterine fibroids would aid prevention and treatment efforts. With NICHD support, researchers developed a prototype gene-based risk score with the potential to predict the development and eventual severity of uterine fibroids. The investigators analyzed genome-wide scans and health records to create polygenic risk scores—the probability that a person would have a particular pattern of fibroid symptoms and characteristics based on their pattern of variant genes.

One of the aspirational goals from the NICHD Strategic Plan is to accelerate efforts to definitively diagnose, prevent, and treat endometriosis, a common gynecological condition that frequently causes debilitating pain and infertility. Endometriosis occurs when tissue that is similar to the lining of the uterus grows in other places in the body. An NICHD-funded study in mice demonstrated that magnetic hyperthermia—a procedure that uses heat to remove disease-causing tissues—may work as a non-surgical treatment for endometriosis. While these findings are early stage, they suggest a potentially safe and efficient method to remove endometriosis tissue.

NICHD research addresses the health of women across the globe. In low- and middle-income countries, many women live with obstetric fistula, a condition that can develop after prolonged or obstructed labor and that leads to urinary and/or fecal incontinence. Because the symptoms are often stigmatized in these countries, the prevalence of obstetric fistula is difficult to discern, making it challenging to develop appropriate prevention and treatment strategies. By combining survey data with clinical examinations, one NICHD-funded study estimated that about 17,500 women in Bangladesh were living with obstetric fistula. This study is the first to empirically estimate national obstetric fistula prevalence and incidence rates. While the findings can assist in planning public health efforts to address obstetric fistula in Bangladesh, the impact is much broader. The methods developed in the study can be adapted to help with public health planning in low- and middle-income countries around the world.

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