Using gene regulation to treat uterine fibroids. Each year, more than 200,000 women in the United States undergo a hysterectomy to treat the chronic pain and abnormal bleeding caused by fibroids.[i]  NICHD-supported scientists are exploring alternative ways to treat fibroids without surgery. Previously, these researchers identified a multifunctional molecule called transforming growth factor beta (TGF-β) that acts as a major regulator of several processes that lead to the growth of uterine fibroids. Using gene microarray technology—a powerful new tool that allows multiple genes to be examined simultaneously—the researchers identified the different genes targeted by TGF-β action in normal and fibroid cells. Armed with this knowledge, the researchers then tested a gene therapy that appeared to block production and action of TGF-β. TGF- β has potential implications in other aspects of women’s reproductive health, including endometriosis. Ongoing research to discover the function of genes in uterine fibroids may provide further insight into developing novel, non-surgical therapeutic approaches, not only to prevent uterine fibroid growth, but also to treat other reproductive conditions. Successful nonsurgical therapies for these conditions would eliminate surgical risk and the need for anesthesia, reduce recovery times, and help to lower health care costs.

Popular contraceptive’s effect on bone loss is reversible. Understanding the potential impact of taking hormones is one of the many factors that influence a woman’s choice of contraceptive method. To provide women and clinicians with more reliable information on which to base these decisions, the NICHD is funding several studies to evaluate the impact of Depo-Provera (depot medroxyprogesterone acetate or DMPA) on bone density in women of various ages and racial groups. Depo-Provera is an injectable hormonal contraceptive that lasts for three months. In this study, researchers compared the bone densities of healthy adolescent females who were already using DMPA to the bone densities of a matched group not using the product. The researchers focused on younger women because approximately 10 percent of adolescents (compared to 3 percent of women overall) use DMPA as a contraceptive, and because women develop most of their bone mass during their adolescent years. The researchers found that, although bone loss occurs while using Depo-Provera, the young women fully regained their bone density after discontinuing use of the product. DPMA is more than 99 percent effective and is the only injectable contraceptive available in the United States. This research should help women choose reliable, practical contraceptives with assurance that they need not increase their future risk of osteoporosis or bone fractures.