Many people face the monthly menstrual struggle of periods: from bleeding and cramps, to violent mood swings. Periods can cause a recurring disruption to everyday life, and many rely on hormonal birth control to regulate bleeding and regain control over their bodies. However, for those who suffer from heavy menstrual bleeding (HMB), periods are more than a painful inconvenience. New research at the University of Edinburgh has for the first time revealed the cause of HMB, offering the possibility for treatment.
HMB is a common condition, affecting up to 30 per cent of pre-menopausal people. However, its symptoms are severe, and can even lead to anemia. In serious cases, those suffering from the condition turn to treatments with uncomfortable side effects that can impair fertility, such as hormonal therapies or even surgery. HMB can have multiple causes, however. In around 50 per cent of cases, this remains unknown.
Researchers at the university’s MRC Centre for Reproductive Health have identified a protein that is key to preventing HMB. Scientists studied the womb lining (endometrium) that is shed during menstruation, resulting in a wound-like surface. This needs to be repaired fast to limit bleeding, with slow repair resulting in longer and heavier periods – both symptoms of HMB.
The research revealed that low levels of oxygen (hypoxia) in the endometrium triggered production of a protein called HIF-1, which helps to repair the womb lining. People with HMB were found to have lower levels of HIF-1 at menstruation than those with ‘normal’ menstrual bleeding. In HMB cases where the cause is unknown, the lack of hypoxia and the associated HIF-1 protein may be to blame.
The researchers additionally discovered that boosting HIF-1 protein production repaired the endometrium and reduced bleeding in mice, sparking hope of a similar treatment for humans. Mice with low levels of oxygen and higher levels of HIF-1 showed faster repair than mice exposed to too much oxygen. At one point, 56 per cent of mice with more HIF-1 showed complete womb repair, compared to only 22 per cent of mice with less. The findings show that both hypoxia and HIF-1 are vital in repairing the womb lining, and thus in reducing HMB.
The Student spoke to Dr Jackie Maybin, clinical lecturer in obstetrics and gynaecology at MRC and leader of the study, who is optimistic.
Dr Maybin hopes that, “this research will lead to new, non-hormonal treatments” for any individual with the condition to “take at the time of bleeding to lighten or normalise their menstrual bleeding . . . the next step is to study its mechanisms.
“We hope to proceed to a clinical study of this compound in the next 10 years.”
The new research may offer a future alternative to hormonal and surgical treatments for those with HMB. By learning more about how the endometrium continually repairs itself, scientists could also apply this mechanism to other organs and tissues where scarring is an issue. Overall, the study is a crucial first step in preventing a natural function from impairing everyday life, and incites discussion around the supposedly ‘embarrassing’ unspoken issue of heavy menstrual bleeding.
Image credit: The Period Blog via Wikimedia Commons