Myometrial Physiology and Its Relation to Pelvic Pain

Woodbury, Robert A.

doi:10.1001/jama.1947.02880300023007

Cited by 67 publications

(23 citation statements)

References 6 publications

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“…A common disorder that mainly affects young women, dysmenorrhea can become invalidating for many women from one to several days each month and can be the cause of numerous missed workdays. In women with dysmenorrhea, early follicular phase uterine contractility is characterized by an increase in resting IUP (resting tone) and UC amplitude, duration, and frequency 5. These characteristics of dysmenorrhea can all be assessed by IUP recording; unfortunately, it is an invasive method.…”

Section: Uterine Contractility During the Luteofollicular Transition mentioning

confidence: 99%

“…In women with dysmenorrhea, early follicular phase uterine contractility is characterized by an increase in resting IUP (resting tone) and UC ampli-tude, duration, and frequency. 5 These characteristics of dysmenorrhea can all be assessed by IUP recording; unfortunately, it is an invasive method. Yet to this day, despite high expectation placed on ultrasound evaluations, only one of the characteristics of dysmenorrhea, UC frequency, can reliably be assessed.…”

Section: Dysmenorrheamentioning

confidence: 99%

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Contractility of the Nonpregnant Uterus

Ziegler

Bulletti

Fanchin

et al. 2001

Annals of the New York Academy of Sciences

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Recent renewed interest in uterine contractility stems from the possibility of directly visualizing uterine contractility on images generated by high‐resolution ultrasound probes. During the menstrual cycle, three typical patterns of uterine contractility have been recognized. During the luteofollicular transition and early follicular phase (menses), the contractile event involves all layers of the myometrium and exerts antegrade (from fundus to cervix) expulsive forces. Characteristically, uterine contractions are often perceived by women at the time of menses, sometimes reaching the level of painful cramps (dysmenorrhea). In the late follicular phase, uterine contractility involves only the subendometrial layers of the myometrium and is never perceived by women. The primary function of uterine contractility in the late follicular phase is to facilitate the retrograde (cervix to fundus) transport of sperm towards the distal end of the fallopian tubes where fertilization normally takes place. Finally, the uterus reaches a stage of quiescence after ovulation (under the influence of progesterone) that characterizes the major part of the luteal phase. The present review summarizes our understanding of the physiological role of uterine contractility during the follicular phase and the possible implications in pathological circumstances such as endometriosis and dysmenorrhea.

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Section: Uterine Contractility During the Luteofollicular Transition mentioning

confidence: 99%

Section: Dysmenorrheamentioning

confidence: 99%

Contractility of the Nonpregnant Uterus

Ziegler

Bulletti

Fanchin

et al. 2001

Annals of the New York Academy of Sciences

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“…Dysmenorrhea is related to an elevated basal intrauterine pressure tone and alters the frequency, amplitude and duration of uterine contraction [44]. Since uterine contractions of the JZ in non-pregnant uterus are oxytocin dependent, OTR may be involved in dysmenorrhea.…”

Section: Discussionmentioning

confidence: 99%

The abnormal expression of oxytocin receptors in the uterine junctional zone in women with endometriosis

Huang

Guo

et al. 2017

Reprod Biol Endocrinol

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BackgroundThe junctional zone (JZ), also called as the endometrial-myometrial junction, is related to peristaltic-like movements in the non-pregnant uterus. Hyperperistalsis and dysperistalsis of uterus constructions might underlie many important disorders such as dysmenorrhea, infertility, endometriosis, implantation failure. The major proteins for uterine contraction of the non-pregnant uterus may be Oxytocin (OT) and oxytocin receptor (OTR). The objective of this study was to inspect the expression of OTR in isthmic and mid-fundal parts of the uterine junctional zone at different stages of the follicular cycle in patients with and without endometriosis.MethodsUterine biopsies containing endometrium and junctional zone were collected from the isthmic and mid-fundal parts of the anterior wall after hysterectomy. The OTR expression was evaluated by immunohistochemistry.ResultsIn the control uterus, OTR expression in the isthmic region was significantly higher than in the fundal region in the proliferative phase (p < 0.05) but significantly lower in the secretory phase (p < 0.05). And the expression of OTR in the proliferative phase was significantly higher than that in the secretory phase in both isthmic and fundal regions (p = 0.000 and 0.049, respectively). However, in endometriosis uteri, OTR expression in the isthmic region showed no significant difference with that in the fundal region in both proliferative and secretory phases (p = 0.597 and 0.736, respectively). In both isthmic and fundal regions, OTR expression was not significantly different between the proliferative phase and secretory phase (p = 0.084 and 0.222, respectively). OTR expression in fundal regions of revised ASRM I and II endometriosis were lower than that of revised ASRM III and IV (p = 0.049). In the fundal region of JZ, the expression of OTR in ovarian endometriosis was significantly lower than that in deep infiltrating endometriosis (p = 0.046). The expression level of OTR in the funds region is positively associated with the severity of dysmenorrhea in endometriosis group (r = 0.870, p < 0.05). Comparing to normal uteri, the expression of OTR in the secretory phase was significantly higher in the endometriosis uteri (p < 0.05). In the fundus of endometriosis uteri, OTR expression was significantly higher in both the proliferative and secretory phases (p = 0.045 and 0.028, respectively).ConclusionOTR expression in the JZ of women with endometriosis changes significantly, which may result in abnormal uterine contractile activity, reducing the endometriosis-related fertility and dysmenorrhea.

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“…As in other types of smooth muscle, spontaneous and drug-induced contractions of the myometrium are related to the concentration of intracellular calcium ions. Conceptually the increase in intracellular free calcium associated with contraction may be produced by (1) an increased influx from the extracellular medium, (2) translocation of calcium ions in or near the cell membrane, or (3) the release of calcium from intracellular stores.23 In experiments in vitro, the importance of extracellular calcium in the activation of the myometrium has been demonstrated. Calcium seems to play dual roles in the electrical activity of uterine smooth muscle.…”

Section: Excitation-contraction Coupling In the Myometriummentioning

confidence: 99%

Calcium Antagonists and Dysmenorrhea

Andersson

1988

Annals of the New York Academy of Sciences

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Myometrial Physiology and Its Relation to Pelvic Pain

Cited by 67 publications

References 6 publications

Contractility of the Nonpregnant Uterus

Contractility of the Nonpregnant Uterus

The abnormal expression of oxytocin receptors in the uterine junctional zone in women with endometriosis

Calcium Antagonists and Dysmenorrhea

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