Premenstrual and menstrual ischemia and the myth of endometrial arteriovenous anastomoses

Bartelmez, G. W.

doi:10.1002/aja.1000980106

Cited by 25 publications

(9 citation statements)

References 11 publications

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“…Some former myths have been exploded. First, the myth of endometrial arteriovenous anastomoses (Bartelmez 1956), and this is supported by the work of V. V. Glaviano (1963). No arteriovenous anas-vein(in the rabbit) from one uterine hornwill tomoses connecting the spiral arteries cause haemorrhage in the corresponding with the sinusoids have been identified placental area.…”

Section: Bloxam Ends His Historic Paper As Followsmentioning

confidence: 92%

The Utero‐placental Circulation: Historiae Fides. II

1965

Develop Med Child Neuro

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Section: Bloxam Ends His Historic Paper As Followsmentioning

confidence: 92%

The Utero‐placental Circulation: Historiae Fides. II

1965

Develop Med Child Neuro

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“…He notes that in any particular rhesus menstrual cycle, the amount of tissue shed is positively correlated with the extent of development and coiling of the spiral arteries. Bartelmez (1956), however, argues that the coiling of the arteries is not essential for menstruation because the same degree of bleeding and tissue sloughing occurs in areas of the rhesus monkey endometrium where the coiling of the arteries is minimal as occurs in areas where the coiling is tortuous. Kaiser (1947), on the other hand, believes that the degree of coiling partly determines the degree of bleeding and shedding of the endometrium, but he assumes the following: first, that gross external bleeding occurs in Old World monkeys and apes, whereas only microscopic bleeding occurs in New World monkeys; and, second, that Old World monkeys and apes have spiral arteries, whereas New World monkeys lack them.…”

Section: The Physiology O F Menstruation Shows Adaptive Designmentioning

confidence: 99%

“…Thus, when the constricted spiral arteries begin to relax, the menstrual blood flows easily from them. The low coagulability of menstrual blood has been one of its most conspicuous characteristics throughout decades of menstruation research (Bartelmez, 1937). In a normal human skin wound, the surrounding blood vessels are occluded by hemostatic plugs that contain platelets and fibrin, which prevent large quantities of blood from escaping.…”

Section: The Physiology O F Menstruation Shows Adaptive Designmentioning

confidence: 99%

Menstruation as a Defense Against Pathogens Transported by Sperm

Profet

1993

The Quarterly Review of Biology

106

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Sperm are vectors of disease. During mammalian insemination bacteria from the male and female genitalia regularly cling to sperm tails and are transported to the uterus. I propose that menstruation functions to protect the uterus and oviducts from colonization by pathogens. Menstrual blood exerts mechanical pressure on uterine tissue, forcing it to shed, and delivers large numbers of immune cells throughout the uterine cavity, directly combating pathogens. The mechanisms of menstruation show evidence of adaptive design. Spiral arteries that open to the lining of the uterus trigger menstruation by abruptly constricting, which deprives the local tissue of blood, and then abruptly dilating, which causes blood to force loose the necrotic tissue. Menstrual blood flows easily, unlike blood at most wound sites, because it lacks the normal level of clotting factors. Overt (externally visible) or covert (not externally visible) menstruation has been documented in many species of primate, including Old World monkeys and apes, New World monkeys, and prosimians, as well as in various species of bat and insectivore. The antipathogen hypothesis predicts that: (1) menstruation (overt or covert) is either universal or nearly so among mammalian species; (2) if the latter, then the existence of menstruation among species varies inversely with the probability of becoming pregnant per estrous cycle (menstruation would be especially adaptive in species with significantly less than 100% probability of becoming pregnant per estrous cycle); (3) among menstruating species, the average degree of menstrual bleeding for a given species is a function of the factors affecting menstruation's costs and benefits--in particular, the degree of bleeding is positively correlated with the average body size and sexually transmitted pathogen load of that species (profuse bleeding would be especially adaptive in large-bodied species with either promiscuous breeding systems or continuous sexual receptivity); and (4) other forms of normal uterine bleeding--proestrous, periovulatory, implantation, and postpartum--also have an antipathogen function. The hypothesis presented in this article has implications for the diagnosis, treatment and prevention of uterine infection and, therefore, for the prevention of pathogen-induced infertility. The uterus appears to be designed to increase its bleeding if it detects infection: Human uteri that become infected (or otherwise inflamed) bleed more profusely, bleed on more days per cycle, and often bleed intermittently throughout the cycle. Thus artificially curtailing infection-induced uterine bleeding may be contraindicated.

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“…Sheppard and Bonnar (1980) described an increase in the diameter of the capillaries in the post-ovulatory phase. It has also been postulated that a close connection exists between the thin capillaries and the venules by arteriovenous shunts and that this connection gives rise to 'venous lakes' (Schlegel, 1945;Dalgaard, 1945;Bartelmez, 1956). Later, Ramsey (1977) claimed that the function of the so-called 'venous lakes' was to regulate the blood volume and the rate of blood flow in the superficial part of the endometrium.…”

Section: Introductionmentioning

confidence: 99%

The endometrial capillaries during the normal menstrual cycle: a morphometric study

Peek

Landgren²,

Johannisson³

1992

Human Reproduction

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The areas of the capillary lumen, the entire capillary, the endothelial cells and the adventitia, as well as the thickness of the endothelial cell layer and the adventitia were studied using morphometric methods in endometrial samples from 34 fertile women who had a hormonal profile compatible with normal ovarian function. The biopsies were grouped around the luteinizing hormone surge. The results were calculated as mean values of 72-h periods and related to the mean levels of oestradiol and progesterone circulating in plasma 72 h prior to the biopsy. The results indicated that the sub-epithelial capillary plexus of the human endometrium undergoes dynamic changes during the normal menstrual cycle with a significant dilatation of the vessels during the post-ovulatory phase. A significant correlation was found between the area of the capillary lumen and the mean level of progesterone circulating in the plasma 72 h prior to the biopsy (P = 0.037). We conclude that the ovarian steroids produced during the normal menstrual cycle are likely to influence sub-epithelial vascularization causing dilatation in the post-ovulatory phase. This dilatation of the sub-epithelial capillaries may be related to the development of oedema appearing in the stroma at the time of the expected implantation. The possible functional significance of the capillary dilatation in terms of implantation, however, needs to be further investigated.

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Premenstrual and menstrual ischemia and the myth of endometrial arteriovenous anastomoses

Cited by 25 publications

References 11 publications

The Utero‐placental Circulation: Historiae Fides. II

The Utero‐placental Circulation: Historiae Fides. II

Menstruation as a Defense Against Pathogens Transported by Sperm

The endometrial capillaries during the normal menstrual cycle: a morphometric study

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