Breast Cancer and Oral Contraceptives. Oral contraceptives are the most widely used method of family planning among women in their twenties.[1] However, scientific research has produced conflicting information on whether taking oral contraceptives increases a woman's risk of breast cancer during her mature years, the period of highest risk. Recently, a very large study showed that women who took oral contraceptives at some point in their lives were no more likely to develop breast cancer between the ages of 35 and 64 than other women. The study also showed that oral contraceptives do not pose a higher risk of breast cancer for African American women or for women whose nearest female relatives had breast cancer. The large scale of the study, carried out through the NICHD Women's Contraceptive and Reproductive Experiences Study (Women's CARE), increases confidence in the results.

Osteoporosis and Injectable Contraceptives. Osteoporosis, a disease that thins and weakens bones to the point that they break easily, is a major health risk for 28 million Americans, especially women. More than 1.5 million fractures annually are related to osteoporosis and, in older individuals, fractures may end the ability to live independently or even lead to death.[2] Injectable contraceptives have been implicated in osteoporosis, but evidence has been inconclusive. In the largest and longest study to date of the relationship between injectable contraceptives and bone density, the scientists followed women for four years as they used, and then stopped using, the injectable contraceptive, DMPA. The study showed that women lost bone density while using DMPA, but that a large majority recovered most of their lost bone mass within two years of stopping use of the contraceptive. These findings may reassure women who have used DMPA and may prefer to continue its use, because of its convenience and reliability. But the findings indicate more research is needed with the youngest women(ages 18-21) using DMPA, because their recovery of lost bone mass after stopping DMPA was less clear.

A Genetic Disorder in Girls. Rett Syndrome (RTT) is a severe genetic disorder that gradually halts healthy development in infant and toddler girls. Girls with RTT lose the ability to talk, to interact with other people and to move independently. They may experience seizures and behavior disorders. Scientists do not know how to cure RTT or halt its progression. Recently, NICHD-supported researchers created a genetically modified mouse with RTT-like symptoms that should help scientists understand how RTT develops over time. The experimental mouse may lead to better understanding of molecular events underlying certain stages of RTT and may enable researchers to identify genes involved in regulating motor function, involuntary movements, seizures, and anxiety disorders. The new mouse is superior to earlier experimental mouse models of RTT and it may enable scientists to test medications and other treatments for the disease.

Endometriosis and the Immune System. Endometriosis is a complex gynecological disorder associated with pelvic pain and infertility that affects more than 5.5 million women in North America alone.[3] Endometriosis occurs when tissue like that which lines the uterus grows outside of the organ, usually on surfaces in the pelvic and abdominal areas. A single, clear explanation for the cause of this disease has eluded scientists. Recently, scientists reported that women with endometriosis are more likely than others to have autoimmune diseases such as rheumatoid arthritis and multiple sclerosis, in which the body's immune system attacks its own cells, tissues and organs. These diseases affect millions of Americans and some disproportionately affect African Americans, Hispanics or Native Americans.[4] The researchers also found that women with endometriosis were more likely than others to have a variety of other conditions, including chronic fatigue syndrome (strong, lasting fatigue) and fibromyalgia (recurrent muscle, tendon and ligament pain). The findings of multiple conditions that seem to relate to endometriosis and immune system function could yield clues to the causes and better treatment of the associated conditions, as well as endometriosis.

Endometriosis and Immune Response. For many women with endometriosis, treatment with progestins (hormones that prepare the lining of the uterus for implantation of a fertilized egg) can relieve pelvic pain and certain other symptoms. But scientists have questioned the utility of progestin therapy on a long-term basis and some women with endometriosis do not gain pain relief from this treatment. Scientists have long recognized that immune cells and products they secrete, known as cytokines, play an important role in the cellular events that occur as endometriosis develops, particularly as the disease process relates to pain. Recently, scientists reported that the way progestin reduces pelvic pain in endometriosis involves suppression of inflammatory response in the pelvis to endometrial tissue. Understanding the way that the drug works provides insight into both the disease process of endometriosis and the reason that progestin does not always relieve endometriosis-related pain. This knowledge could lead to better therapies for endometriosis.

Uterine Fibroids and Genes. More than a quarter of U.S. women may develop uterine fibroids, the most common non-cancerous tumors in women of childbearing age.[5] The tumors can cause infertility, pain, and uterine bleeding. Treatment options are limited to hormone therapies and surgery, with fibroid tumors accounting for an estimated 200,000 hysterectomies each year.[6] African American women are at greater risk for surgery because they are more likely to develop large or multiple-fibroid tumors. Recently, scientists, using a new technology that permits very rapid analysis of multiple genes, were able to identify genes involved in the development and growth of fibroid tumors. Identifying genes specific to the condition will help scientists better understand how the tumors grow and could lead ultimately to the development of new therapies for this condition. The researchers plan further genetic studies, to identify a "master regulator" of tumor growth and to develop drugs that could shrink fibroids, sparing women from surgery and side effects of other current therapies.