| Advances in Uterine Leiomyoma Research: The Progesterone Hypothesis Mitchell S. Rein North Shore Medical Center, Brigham and Women's Hospital, Harvard Medical School, Cambridge, Massachusetts, USA; Women's Health Center of the North Shore, Danvers, Massachusetts, USA Abstract
Uterine leiomyomas are monoclonal tumors. However, the factors involved in their initiation and growth remain poorly understood. The neoplastic transformation of myometrium to leiomyoma likely involves somatic mutations of normal myometrium and the complex interactions of sex steroids and local growth factors. Traditionally, estrogen has been considered the major promoter of myoma growth. The purpose of this review is to highlight the biochemical, histologic, and clinical evidence that supports an equally important role for progesterone in the growth of uterine myomas. Biochemical studies suggest that progesterone, progestins, and the progesterone receptor modulate myoma mitotic activity. A hypothesis to explain the pathogenesis of myomas is presented. Key words: fibroids, leiomyoma, myomas, pathogenesis, progesterone, uterus. -- Environ Health Perspect 108(suppl 5) :791-793 (2000) . http://ehpnet1.niehs.nih.gov/docs/2000/suppl-5/791-793rein/abstract.html
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