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Endometrial leukocytes and menstruation.

L A Salamonsen¹, L J Lathbury

¹Prince Henry's Institute of Medical Research, Clayton, Victoria, Australia. lois.salamonsen@med.monash.edu.au

Human Reproduction Update

|March 11, 2000

Summary

Menstruation is an inflammatory process involving leukocytes in the endometrium. Their activation and released products, including proteases and cytokines, drive tissue breakdown characteristic of menstruation.

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Area of Science:

Reproductive Biology
Immunology
Gynecology

Background:

Menstruation involves complex physiological processes within the endometrium.
The role of inflammatory mediators in endometrial breakdown is an area of ongoing research.

Purpose of the Study:

To review evidence supporting menstruation as an inflammatory process.
To elucidate the role of leukocytes and their products in endometrial breakdown.

Main Methods:

Review of existing scientific literature on endometrial inflammation and menstruation.
Analysis of the involvement of various leukocyte types (mast cells, eosinophils, neutrophils, macrophages, granular lymphocytes).

Main Results:

Leukocyte numbers increase in the late secretory phase, coinciding with a drop in progesterone.
Activated leukocytes release proteases, chemokines, and cytokines, leading to matrix metalloproteinase activation and tissue breakdown.
Local endometrial cells produce chemokines and cytokines that regulate leukocyte activity.

Conclusions:

Menstruation is strongly supported as an inflammatory process.
Leukocyte-derived factors are critical for endometrial tissue breakdown during menstruation.
The precise regulatory mechanisms of leukocyte activity and progesterone's indirect role require further investigation.

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