Progesterone: a little-known role of the well-known hero

Abstract

Endometrial polyps and chronic endometritis are two most common causes of unexplained infertility in women of reproductive age.The aim of our study was to conduct a comparative analysis of the hormonal homeostasis and the state of the receptor apparatus of the endometrium in women of reproductive age with endometrial polyps and micropolyps.For a research 4 groups of women were chosen: 34 women with endometrial polyps (IA group), 36 patients with endometrial polyps and micropolyps (IB group), 30 women with micropolyps (IІ group) and 30 healthy women (ІІІ group). In all groups of women the content in blood serum for 3–5 day of a menstrual cycle of gonadotropic hormones (follicle-stimulating hormone, luteinizing hormone) and sex steroid hormones (estradiol, prolactin) was studied, for 21 days of a cycle estimated the content of progesterone. Level of an expression of receptors of progesterone and estrogen estimated in endometrium and at endometrial polyps, also in І a cycle phase.The conducted research revealed reliable decrease in level of progesterone at women with endometrial polyps against the background of lack of significant changes in the receptor device. At patients with micropolyps the tendency to a hypoprogesteronemia was also observed, but changes in an expression of steroid receptors it was not also revealed.The authors conclusion is the low concentration of progesterone initiate non-hormonal pathophysiological mechanisms of development of endometrial polyps which should be considered at purpose of antirecurrent therapy.Thus, in case of progesteron deficit perverse mechanisms literally overlap in an attempt to start the process of tumor. Inflammation is an important component of the physiological menstrual cycle, during prolonged hypoprogesteronemia it becomes pathological. It is directly involved in the formation of such a microenvironment for endometrium in which the mechanisms of fibrosis fully realize their potential, cell proliferation and angiogenesis, creating a strong foundation for the subsequent formation and growth of endometrial polyps. To date, it is proved that an imbalance in estrogen-progesterone system actually increases the risk of developing endometrial polyps, but not always through steroid receptors.