Estrogen plays an important role in the pathogenesis of uterine fibroids

Estrogen plays a key role in the growth of uterine fibroids. Studies have found that the mitosis of leiomyoma becomes active during the luteal phase and is maintained at a high level during the menstrual period. Ovarian hormones can promote the growth of uterine fibroids through cytokines or growth factors. Estrogen can also regulate the gene expression of these growth factors and cytokines and affect the transcription of other genes. The abnormal proliferation of these cytokines and growth factors can promote mitosis, cause cell proliferation, and accumulate extracellular matrix.

Estrogen receptors can promote the growth of uterine fibroids. Some scholars have used dominant negative estrogen receptor genes to transcribe heterodimers, which can block the binding of normal estrogen heterodimers to ERE in the cell nucleus and block the effects of estrogen. The results showed that apoptosis of uterine fibroid cells increased and fibroid growth stopped.

In addition, uterine fibroids contain aromatase, which can synthesize estrogen by itself. The content of aromatase in uterine fibroid tissue is far higher than that in normal muscle layer. In vitro experiments show that stimulating aromatase activity can promote the proliferation of fibroid cells, while inhibiting aromatase activity can inhibit its proliferation. Cultivating uterine smooth muscle cells with androstenedione can convert steroid hormone precursors into estrone, which needs to be converted into estradiol to fully exert its effect. Aromatase plays a key role in this process.