Author: Christine Chen
Editors: Sophia Chen, Kevin Yao
Artist: Astrid Chen
Statistically, over 26% of the population has experienced menstruation, commonly referred to as “that time of the month” or periods. This is an important process for an individual to maintain homeostasis and prepare their uterus for pregnancy each cycle. That one week can be packed with various symptoms, including emotional distress, headaches, cramping, and more. However, researchers have found a way to make menstrual blood useful in treating various illnesses, thanks to the discovery of one key component: stem cells.
About 20 years ago, Caroline Gargett studied cells from the endometrium, the inner lining of the uterus, which were collected during hysterectomy surgeries, a procedure where the uterus is surgically removed. When examining the petri dish where she had cultured these cells, she noticed that they appeared to be mesenchymal stem cells (a type of stem cell found in the tissue supporting the endometrium and could develop into many different cell types in the body).
Stem cells have been identified in bone marrow, brain, heart, and muscles, but never in the endometrium. These cells are highly desired because of their ability to become many cell types, such as muscle cells, brain cells, blood cells, and more. This ability can help treat cancer, heart failure, Alzheimer's, and many other diseases. Although mesenchymal stem cells are slightly limited in the types of cells they can become, they are still highly sought after. However, stem cells are rare, and the methods for obtaining them can be looked at unfavorably. The two main ways to collect stem cells are from the bone marrow or muscles of adult humans, or from embryos created through in vitro fertilization. Adult humans have very few stem cells, and the ethics of using and killing embryos is hotly debated. Therefore, finding a less controversial way to obtain stem cells is highly desirable.
Gargett and her colleagues went on to study these cells further. They found that only the endometrial stromal mesenchymal stem cells could become other cell types. These cells are slightly different from stem cells because they are obtained from tissue and have limited abilities to change into other cells. Interestingly, these cells were also discovered in menstrual blood. This means that instead of using invasive procedures like bone marrow extraction or collecting cells from the endometrium, simply collecting menstrual blood in a cup would work much better.
This discovery can lead to several cures, but one major research focus of this newly developed tool is its potential to diagnose and cure endometriosis. Endometriosis is a condition that affects more than 10% of women–about 190 million people worldwide–and causes severe pain, particularly during menstruation. Although the condition isn’t fully understood, one theory suggests it is caused by retrograde menstruation, where endometrial tissue flows backward through the fallopian tubes—where the egg is carried from the ovaries to the uterus—into the pelvic cavity. There, it will attach itself to the ovaries of the pelvic lining, creating painful lesions that may lead to infertility. Another theory proposes that endometriosis could originate from stem cells. These cells might travel into the pelvic cavity and transform into different types of tissues, creating endometriosis lesions. Researchers think the menstrual stem cells play a significant role in this process, as they have the ability to renew themselves and contain proteins that help them move into the pelvic cavity.
Researchers have also examined the differences between normal mesenchymal stem cells (MenSC) and those from women with endometriosis (E-MenSC). They found differences in appearance and behavior. For instance, E-MenSCs have a distinct shape (morphology) compared to normal MenSCs, and they tend to form small colonies when cultured, which normal MenSCs do not. E-MenSCs also show enhanced abilities to attach, migrate, grow, and invade, meaning they are more likely to survive and spread within the pelvic cavity. This is partly due to a lower Bax/Bcl-2 ratio, which means there is reduced cell death. Furthermore, E-MenSCs seem to produce more vascular endothelial growth factor (VEGF), a protein that promotes the formation of new blood vessels, explaining why endometrial lesions grow and spread.
Given these differences, researchers suggest that comparing MenSCs from individuals suspected of having endometriosis to normal MenSCs could lead to early diagnosis of the condition, even before symptoms appear.
Menstrual stem cell-based therapies are promising because they can be obtained non-invasively and have the potential to treat many conditions. They can move to certain injured areas, and change into a different cell type that can release helpful substances and manage the immune response. This makes them a great tool for treating immune-related diseases and also helps improve endometriosis. However, this promising cure and diagnostic tool is still extremely limited because of the taboo of menstrual blood and a lack of funding. The public needs to come together and help aid in the advancement of studies like this and forget the taboos.
Citations:
“Fast Facts: Nine Things You Didn’t Know about Menstruation.” UNICEF,
www.unicef.org/press-releases/fast-facts-nine-things-you-didnt-know-about-
%20around%20the%20world. Accessed 21 Aug. 2024.
NHS Choices, NHS, www.hra.nhs.uk/planning-and-improving-research/application-
summaries/research-summaries/menstrual-blood-collection-and-stem-cell-extraction/. Accessed 21 Aug. 2024.
“The Untapped Potential of Stem Cells in Menstrual Blood.” Gavi, the Vaccine Alliance, 8 Feb.
2024, www.gavi.org/vaccineswork/untapped-potential-stem-cells-menstrual-
blood#:~:text=Stem%20cells%20from%20the%20endometrium,heart%2C%20liver%20
and%20ski n%20cells.
“Endometriosis.” World Health Organization, World Health Organization,
www.who.int/news-room/fact-sheets/detail/endometriosis. Accessed 21 Aug. 2024.
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