As many as 75 percent of women have uterine fibroids (leiomyomas), and approximately one-third to one-half of those women become symptomatic at some point during their reproductive lives - experiencing irregular uterine bleeding, anemia, pelvic pain or recurrent pregnancy loss.
"Uterine fibroids represent the most prevalent benign gynecologic problem in our nation. This is truly an understudied area and a serious public health problem," said Serdar E. Bulun, M.D., George H. Gardner professor of clinical gynecology and chief of the division of reproductive biology research at Northwestern University Feinberg School of Medicine, who also is a physician at Northwestern Memorial Hospital.
Thanks to $5.7 million in funding from the Eunice Kennedy Shriver National Institute of Child Health and Development, part of the National Institutes of Health, Bulun and researchers at the Uterine Leiomyoma Research Center at Feinberg have the funding they need to continue investigating new treatments of uterine fibroids.
Principal investigator of the center grant, Bulun is studying the cause of this chronic problem, as well as treatment options such as investigating hormonal pathways and defining molecular targets for existing or upcoming pharmaceutical compounds developing novel and alternative management options.
Bulun's research suggests that the hormone progesterone, which enables and activates fibroid growth during childbearing years, stimulates uterine fibroids. His recent work uncovered the mechanism as to how a class of drugs called selective progesterone receptor modulators reduces fibroid size and associated symptoms. The mechanisms regulating the development and growth of these tumors are still not well understood, however, so treatment options for fibroids are limited.
Besides Bulun, Julie Kim, Debu Chakravarti, Takeshi Kurita, and Erica Marsh, M.D., from Feinberg and Romana Nowak, from University of Illinois at Urbana-Champaign, lead key projects at the Uterine Leiomyoma Research Center.
Uterine fibroids are typically treated surgically, through a myomectomy or hysterectomy, or using newer technologies involving interventional radiology or high-intensity ultrasound. GnRH agonists, developed in the 1980s, are the only class of drugs available to treat fibroids, but their success is extremely limited, and side effects prevent long-term use of the medication.
The renewable five-year P01 Program Project offers Bulun and his colleagues the opportunity to find answers to these uncertainties and diminish the suffering caused by uterine fibroids.
"This center is a unique entity," Bulun said. "We approach the translational aspects of uterine fibroids in a multidisciplinary manner. We hope our research will encourage the pharmaceutical industry and clinicians to set up clinical trials."