L'endomètre postménopausique, son vieillissement normal et pathologique

Translated title of the contribution: Post menopausal endometrium - Normal and pathological endometrial aging

Dominique Pasquier, Maria Alexandre Bettencourt-Pires, Pierre Bernard

Research output: Contribution to journalReview article

Abstract

In view of the endometrial capacities of plasticity and memory, can one consider that this uterine tissue suffers an aging process, comparable to other human tissues? Technical progress and the scientific update of the hormonal treatment of menopause and its endometrial impact (according to the quality of products, dosage, associations and rhythm of prescription), along with the extension of life expectancy, have permitted experimental observations, leading to a better knowledge of post-menopausal endometrium. Technical evolution has recently affected several scientific domains. Endoscopy has technically evolved, materially and in terms of training. Electronic microscopy is now enriched with 3-D imaging. Medical imaging is still evolving, in terms of informatics data processing, dynamic views, and 3-D imagery. Immuno-hysto-chemistry and molecular biology have led to the dosage of VEGF, integrins, bd 2, and the evaluation of biological markers of proliferation and secretion. The interpretation of the angiogenic actions of estradiol and the pathogenesis of metrorragies has enhanced the importance of angiogenesis, of metalloproteinases and their inhibitors. As we discover the amazing potentials of endometrial stem cells, their neuroendocrin and dopaminergic capacities are a recent update. Progress has also been made in terms of a better knowledge of the genetic and molecular scale of physiologic endometrial apoptosis and in the vast domain of post-menopausal malignancy. The above factors also strongly contribute to the triggering of angiogenesis, influencing the actions of tumoral suppressive genes and of the signalling paths of the menopausal endometrium, which is only apparently quiescent, as it keeps every possibility of awakening, under the influence of exogenous or endogenous factors. Pathologists are presently aware of the different stages and evolving risks of endometrial hyperplasia. Great progress has been made in terms of the assessment of the benefits and risks of hormonal treatments of the endometrium. Although the quiescent menopausal endometrium still has the capacity of functional revival, under estrogenic influence, it has not yet unveiled most of its concealed secrets concerning the hidden regenerative and hormonal potentiality.

Original languageFrench
Pages (from-to)273-284
Number of pages12
JournalMedecine Therapeutique Medecine de la Reproduction, Gynecologie et Endocrinologie
Volume12
Issue number4
DOIs
Publication statusPublished - 1 Oct 2010

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Keywords

  • Apoptosis
  • Endometrial aging
  • Endometrium
  • Menopause

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