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ARRA Investments in Women’s Health


Public Health Burden
Thousands of women in the United States are affected by gynecological health issues, and some conditions can affect fertility.  For example, nearly 25 percent of women in the United States suffer from a pelvic floor disorder, as many as 16 percent of women suffer from chronic vulvar pain at some time in their lives, and between 5 percent and 10 percent of women of reproductive age are affected by polycystic ovary syndrome, the most common cause of infertility in women.  Uterine fibroids alone, one of the most common gynecological conditions affecting women during their reproductive years, accounted for 253,000 hospital admissions and resulted in hospital charges of just over $2.6 billion.  Lack of appropriate testing of drugs used during pregnancy also raises a significant concern, with two-thirds of all pregnant women taking at least four medications during pregnancy and labor, use of which is based largely on an empiric approach and not on scientific data.

Treatment
Building on existing research results and research infrastructure, researchers will examine potential new and improved treatments for a variety of gynecological disorders.
  • As groundwork for developing new drugs for uterine fibroids, investigators will study the molecular mechanisms underlying the pharmacological action of progestins and "antiprogestins" on fibroids.1
  • Researchers will determine if a reduced-carbohydrate diet, by lowering circulating insulin, improves reproductive and metabolic health among women with polycystic ovary syndrome; results could lead to a non-pharmacologic treatment.2
  • In a clinical trial to test whether a muscle training program can reduce postoperative symptoms in women undergoing a surgical procedure for urinary incontinence, supplemental funding will expand recruitment into the study and speed completion of the research.3
  • A supplement to the Obstetric and Fetal Pharmacology Research Units network will enhance studies that test the safety of medications that pregnant women use.4
Technology
Innovative advancements and applications of technology are essential in developing interventions for and in examining aspects of gynecological health issues and outcomes.
  • Scientists will test ways to improve transplantation of preserved ovarian tissue back into women and girls whose cancer treatments made them infertile, to enable them to have children.5
  • To help the thousands of women who undergo surgery each year for pelvic floor dysfunction, researchers will use MRI to help determine how injuries to the pelvic organs during childbirth can lead to problems later in a woman’s life.6
  • Researchers will use a non-invasive technology device to study the physiological mechanism of uterine contractions by recording magnetic fields corresponding to electrical activity of the uterine smooth muscle.7
Basic Research
In addition to research on treatments and interventions, basic research is needed to unveil the mechanisms that lead to gynecological health problems, to ultimately develop interventions that prevent or that better treat the condition.
  • Researchers will examine mechanisms that underlie the growth and development of ovarian follicles.  Understanding these mechanisms may help identify causes of and treatments for infertility in women.8
  • Researchers will characterize the role of specific signaling pathways in early vertebrate embryonic development that may shed light on ovarian failure, early onset of menopause, and infertility.9
  • To better understand the molecular basis for the risk of developing uterine fibroids, researchers will conduct a study to identify genetic variants and differences in gene expression.10
  • Researchers will examine the origins of cell differentiation defects in the cells that line the uterus, laying the groundwork for better diagnosis and treatment for endometriosis.11
  • Scientists will test whether an altered immunoinflammatory response, linked to genetic, environmental, or other factors, could help explain vulvodynia.12
  • Researchers will investigate how certain cells in the placenta differentiate and fuse, to better understand the origins of pregnancy complications such as miscarriage and intrauterine growth restriction.13
  • Researchers will identify mechanisms that may regulate the transition to contraction during pregnancy, to provide a biological basis for therapies designed to improve health outcomes.14
  • Researchers will identify factors influencing women’s preferences for cesarean or vaginal birth to better understand recent increases in cesarean births without medical indications for the procedure.15



  1. 1R01HD058640-01 -- The pharmacological actions of antiprogestins in uterine fibroids -- McDonnell, Donald (NC)
  2. 1R01HD054960-01A2 -- Reduced Carbohydrate Diet Intervention for PCOS -- Gower, Barbara (AL)
  3. 3U10HD041261-09W1 -- Perioperative Pelvic Floor Rehab: A Randomized Trial -- Richter, Holly (AL)
  4. 3U10HD047892-05W1 -- UW Obstetric-Fetal Pharmacology Research Unit -- Hebert, Mary (WA)
  5. 1R21HD061277-01 -- Experimental engineering of ovarian grafting to promote angiogenesis for fertility -- Gosden, Roger (NY)
  6. 3P50HD044406-08W1 -- Birth, Muscle Injury and Pelvic Floor Dysfunction -- DeLancey, John (MI)
  7. 1RC1HD064086-01 -- A new non-invasive technology to diagnose preterm labor -- Lowery, Curtis (AR)
  8. 1R01HD057235-01A2 -- Mechanism of Action of Prohibitin in Ovarian Cell Function -- Thompson, Winston (GA)
  9. 2R01HD032105-11A2 -- Molecular Basis of Neural Development in Xenopus -- Brivanlou, Ali (NY)
  10. 1R03HD057380-01A1 -- Racial Disparity for miRNAs in Uterine Leiomyomas -- Wei, Jian-Jun (IL)
  11. 2R01HD044713-05A1 -- Cell Differentation During Decidualization -- Strakova, Zuzana (IL)
  12. 1R01HD058608-01A1 -- Immunological Factors and Risk of Vulvodynia -- Harlow, Bernard (MN)
  13. 1R01HD059041-01A1 -- Apoptosis and Trophoblast Fusion -- Rote, Neal (OH)
  14. 2R01HD037831-10A1 -- Regulation of Uterine Smooth Muscle Excitability -- England, Sarah (IA)
  15. 1R21HD059074-01A1 -- A Study of the Factors Influencing Women's Decision about Childbirth -- Regan, Mary (MN)


     
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