Embryo Project Encyclopedia

The figure depicts three different molecular structures of estrogen found in mammals’ that differ by the arrangement of bonds and side groups. The molecular structures of the three estrogen molecules differ by the arrangement of chemical bonds and side groups attached to the core steroid structure, cholesterol, which contains three cyclohexane rings and one cyclopentane ring. Compared to the molecular structure of estriol, the molecular structure of estradiol is missing one oxygen-hydrogen or OH group, and estrone lacks the OH group, and one hydrogen molecule that results in a double bonded oxygen atom. These steroid hormones bind to specific cell receptor molecules and induce transcriptional changes in cells. The production of estriol increases during pregnancy, estradiol production increases during stages of the menstrual cycle, and estrone levels increase during menopause. The differing bonds and chemical arrangements enable scientists to determine the different concentrations of the molecules.

James Marion Sims developed a surgical cure for ruptures of the wall separating the bladder from the vagina during labor, ruptures called vesico-vaginal fistulas, and he developed techniques and tools used to improve reproductive examinations and health care for women in the US during the nineteenth century. Sims's lateral examination position allowed doctors to better see the vaginal cavity, and his speculum, a spoon-like object used for increased view into the vagina, helped to make gynecological examinations more thorough. Sims helped ease the physical and social strains of post-birth women who suffered from vesico-vaginal fistulas, and he established the first hospital in New York City, New York, dedicated solely to treating women and improving women's health care.

First marketed in the US 1875, Lydia Pinkham’s Vegetable Compound was an herbal medicine used by women to relieve menstrual discomfort and menopausal symptoms in women. The herbal compound was invented by Lydia Estes Pinkham in 1873 in her home kitchen in Lynn, Massachusetts. Pinkham created the compound by mixing alcohol with roots and herbs. The compound was patented, packaged, and distributed by the Mrs. Lydia Pinkham Medicine Company in 1876. The Mrs. Lydia Pinkham Medicine Company advertised the compound in many US newspapers and magazines, causing Lydia Pinkham’s Vegetable Compound to become a household name and making treatments for female reproductive discomfort mainstream in the US.

Katharina Dorothea Dalton was a physician in England in the twentieth century who defined premenstrual syndrome (PMS) as a cluster of symptoms suspected to begin one to two weeks before menstruation and disappear upon the onset of a new menstrual cycle. Prior to Dalton, there was little research on pre-menstrual issues and those that existed linked the problem to excessive water retention or estrogen. Dalton hypothesized that PMS resulted from a deficiency in the hormone progesterone and advocated for hormone replacement therapy to lessen the symptoms of the syndrome. Dalton established an early PMS clinic in London, England, and she testified on behalf of women in over fifty court cases claiming to have committed crimes while suffering from PMS.

NovaSure is a device for endometrial ablation, which is a procedure that removes the endometrium, that the US Food and Drug Administration, or FDA, approved for use on 28 September 2001. Endometrium is the tissue that lines the uterus. NovaSure destroys the endometrium by sending electric beams at the endometrium. Hologic, a medical technology company concerned with women’s health, developed NovaSure to treat menorrhagia, or heavy bleeding during menstruation. Menorrhagia is a common symptom of endometriosis. Endometriosis is the growth of the endometrium outside of the uterus. While NovaSure is not a treatment that doctors use to directly treat endometriosis, the procedure may help alleviate heavy bleeding during menstruation, which may improve a patient’s quality of life as heavy menstrual bleeding is often associated with high levels of anxiety and low levels of confidence.

In the early twentieth century US, Jean Paul Pratt and Edgar Allen conducted clinical experiments on women who had abnormal menstrual cycles. During the clinical tests, researchers injected the hormone estrogen into their patients to alleviate their menstrual ailments, which ranged from irregular cycles to natural menopause. The hormone estrogen plays a prominent role in the menstrual cycle by signaling the tissue lining the uterus (endometrium) to thicken in preparation for possible pregnancy. In their clinical tests, Pratt and Allen showed that injecting estrogen into female human subjects restored their normal menstrual cycle, removed symptoms such as hot flashes, and caused uterine tissue to grow. The clinical tests conducted by Pratt and Allen provided experimental evidence and justification for the injection of isolated estrogen in women to alleviate, for a short amount of time, different menstrual problems, and it contributed to later hormone therapy research.

Lydia Estes Pinkham invented and sold Lydia Pinkham’s Vegetable Compound, a medicinal tonic used to treat menstrual discomfort and promote female reproductive health in general, in the US during the nineteenth century. Pinkham also founded Mrs. Lydia E. Pinkham Medicine Company, a business that sold natural remedies for women’s health issues. Throughout her life, Pinkham acted as an authority on female wellness, writing medical pamphlets about female anatomy and reproductive processes. In those pamphlets, Pinkham addressed female medical issues that physicians did not frequently discuss with their patients. Pinkham’s advertising techniques and her products helped women learn about their reproductive anatomy and processes and helped ease menstruation.

The Martius flap procedure is a surgical procedure used to treat obstetric fistulas in women. Heinrich Martius developed the procedure in twentieth century Germany to treat women with urinary incontinence caused by stress, and later doctors used it to repair obstetric fistulas. Fistulas occur in pregnant women when a hole is torn between the vagina and the urinary tract (called vesicovaginal) or the vagina and the rectum (called rectovaginal). The hole, or fistula, occurs in the tissue separating two organs and therefore obstetric fistulas result in either urinary or fecal incontinence. Fistulas can occur due to surgery, injury, or chemotherapy, but they most commonly occur in pregnant women who experience prolonged labor and do not have adequate access to obstetric care. As a result of the Martius flap procedure, patients regain functional use of their vaginas without continued urinary or fecal incontinence.

Starting in 1929, the Royal College of Obstetricians and Gynaecologists was a professional association of physicians in the UK that aimed to improve the care of women in childbirth through training and education and to establish obstetrics and gynecology as a medical specialty. The Royal College of Obstetricians and Gynaecologists has contributed to women’s reproductive health by fostering research, establishing standards for physicians specializing in obstetrics and gynecology, and influencing legislation.

In 1953, Raymond Greene and Katharina Dalton, who were doctors in the UK, published The Premenstrual Syndrome in the British Medical Journal. In their article, Dalton and Greene established the term premenstrual syndrome (PMS). The authors defined PMS as a cluster of symptoms that include bloating, breast pain, migraine-headache, fatigue, anxiety, depression, and irritability. The article states that the symptoms begin one to two weeks before menstruation during the luteal phase of the menstrual cycle, and they disappear upon the onset of the menstrual period. Menstruation is the monthly series of changes a woman's body undergoes in preparation for the possibility of pregnancy. Dalton and Greene described how progesterone affected women during different phases of their menstrual cycles. The paper convinced many about the phenomenon of PMS, and docotors and scientists adopted Dalton's and Green's term. The paper furthered research about the role of hormones in physiology and of conditions linked to the reproductive system.