Examining physiological hypoxia at menstruation to define the mechanisms that underpin endometrial resilience and heavy menstrual bleeding

Heavy menstrual bleeding (HMB) is a common debilitating condition. As its cause remains undefined, current medical treatments are non-specific hormonal therapies and the side effects mean that many women end up having surgery that can affect fertility. I have revealed that low oxygen levels (hypoxia) occur in the lining of the womb (endometrium) during menstruation and this drives repair after the lining has been shed. Women with HMB have a defective hypoxic response during menstruation. I significantly improved endometrial repair in a mouse model using an injection that mimics hypoxia,.

I will give mice and women oral medication that mimics physiological endometrial hypoxia to determine if it could be used as a novel, non-hormonal treatment for HMB that can also preserve fertility. Alongside these studies, I aim to determine specific actions of endometrial hypoxia at menstruation and its effects at other times in the menstrual cycle.

This research will lead to precise treatments for women with HMB with limited side effects and improved efficacy.