Regeneration of the endometrium after menstruation requires a rapid and highly organized vascular response. Potential regulators of this process include members of the vascular endothelial growth factor (VEGF) family of proteins and their receptors. Although VEGF expression has been detected in the endometrium, the relationship between VEGF production, receptor activation, and endothelial cell proliferation during the endometrial cycle is poorly understood. To better ascertain the relevance of VEGF family members during postmenstrual repair, we have evaluated ligands, receptors, and activity by receptor phosphorylation in human endometrium throughout the menstrual cycle. We found that VEGF is significantly increased at the onset of menstruation, a result of the additive effects of hypoxia, transforming growth factor-␣, and interleukin-1. Both VEGF receptors, FLT-1 and KDR, followed a similar pattern. However, functional activity of KDR, as determined by phosphorylation studies, revealed activation in the late menstrual and early proliferative phases. The degree of KDR phosphorylation was inversely correlated with the presence of sFLT-1. Endothelial cell proliferation analysis in endometrium showed a peak during the late menstrual and early proliferative phases in concert with the presence of VEGF, VEGF receptor phosphorylation, and decrease of sFLT-1. Together, these results suggest that VEGF receptor activation and the subsequent modulation The cyclic regeneration of the endometrium during the female reproductive years requires a highly regulated angiogenic response.1-5 Physiological changes associated with loss and reconstruction of the functional endometrium during the menstrual cycle are unique to the higher primate species. Humans undergo shedding of the upper spongy layer of the endometrium during menses. 4,6,7 Menstrual bleeding itself is brought on by tissue breakdown and damage surrounding superficial endometrial vessels. Within 5 days of menstrual onset, the damaged endometrial vessels have been repaired. 8 Hence, the initial phase of endometrial angiogenesis involves repair of the vascular bed in concert with the late stages of menstrual shedding and during the proliferative phase. Models of endometrial angiogenesis in the proliferative phase describe the growth of the vasculature under the influence of estrogen, whereas the secretory phase involves growth of the coiled arterioles mediated by progesterone.