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Endometrial sex steroid receptor expression in women with menorrhagia
H O Critchley1, K M Abberton, N H Taylor
1Monash University Department of Obstetrics and Gynaecology, Victoria, Australia.
Objective:
To investigate the oestrogen and progesterone receptor distribution in endometrium from reproductive age and perimenopausal women with and without menorrhagia.
Design:
A comparative observational study.
Subjects:
Forty-five women with objective menorrhagia (27 categorised as reproductive age and 18 as perimenopausal) and a control group of 44 women (31 reproductive age and 13 perimenopausal) with menstrual blood loss of less than 80 ml per period.
Main Outcome Measures:
Oestrogen receptor and progesterone receptor semi-quantitative immunostaining scores.
Results:
Comparison of control and menorrhagic endometrium in this study (whether from reproductive age or perimenopausal subjects) failed to demonstrate any major differences in either sex steroid receptor mean immunostaining score. The results demonstrated a great degree of variability in sex steroid receptor immunoreactivity between individuals. Irrespective of clinical group, significant increases in immunostaining were demonstrated in the proliferative phase of the cycle for immunoreactivity of oestrogen receptor in glands (P < 0.0005), and stromal (P = 0.002) compartments of endometrium and progesterone receptor immunoreactivity in glands (P = 0.009). Progesterone receptor immunostaining in the stromal compartments did not significantly decline (P = 0.06) in the secretory phase.
Conclusions:
Endometrium from women with objective evidence of menorrhagia is indistinguishable in terms of sex steroid immunoreactivity from endometrium of women with normal monthly blood loss. This pattern of sex steroid receptor immunostaining pattern was maintained into the perimenopausal years.