{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T21:26:37Z","timestamp":1789593997129,"version":"build-2803163510"},"reference-count":88,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,12,21]],"date-time":"2021-12-21T00:00:00Z","timestamp":1640044800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Reprod. Health"],"abstract":"<jats:p>\n                    Menstruation is a process whereby the outer functionalis layer of the endometrium is shed each month in response to falling progesterone and estrogen levels in a non-conception cycle. Simultaneously with the tissue breakdown, the surface is re-epithelialized, protecting the wound from infection. Once menstruation is complete and estrogen levels start to rise, regeneration progresses throughout the proliferative phase of the cycle, to fully restore endometrial thickness. Endometrial repair is unique compared to tissue repair elsewhere in the adult, in that it is rapid, scar-free and occurs around 400 times during each modern woman's reproductive life. The shedding tissue and that undergoing repair is bathed in menstrual fluid, which contains live cells, cellular debris, fragments of extracellular matrix, activated leukocytes and their products, soluble cellular components and extracellular vesicles. Proteomic and other analyses have revealed some detail of these components. Menstrual fluid, along with a number of individual proteins enhances epithelial cell migration to cover the wound. This is shown in endometrial epithelial and keratinocyte cell culture models, in an\n                    <jats:italic>ex vivo<\/jats:italic>\n                    decellularized skin model and in pig wounds\n                    <jats:italic>in vivo<\/jats:italic>\n                    . Thus, the microenvironment provided by menstrual fluid, is likely responsible for the unique rapid and scar-free repair of this remarkable tissue. Insight gained from analysis of this fluid is likely to be of value not only for treating endometrial bleeding problems but also in providing potential new therapies for poorly repairing wounds such as those seen in the aged and in diabetics.\n                  <\/jats:p>","DOI":"10.3389\/frph.2021.779979","type":"journal-article","created":{"date-parts":[[2021,12,21]],"date-time":"2021-12-21T00:34:14Z","timestamp":1640046854000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":22,"title":["Menstrual Fluid Factors Mediate Endometrial Repair"],"prefix":"10.3389","volume":"3","author":[{"given":"Lois A.","family":"Salamonsen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,12,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1393","DOI":"10.1093\/humrep\/dep036","article-title":"A re-appraisal of the morphological changes within the endometrium during menstruation: a hysteroscopic, histological and scanning electron microscopic study","volume":"24","author":"Garry","year":"2009","journal-title":"Hum Reprod."},{"key":"B2","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1111\/j.1749-6632.1991.tb37848.x","article-title":"Microarchitecture of the human endometrium by scanning electron microscopy: menstrual desquamation and remodeling","volume":"622","author":"Ludwig","year":"1991","journal-title":"Ann N Y Acad Sci."},{"key":"B3","doi-asserted-by":"publisher","first-page":"e2000211","DOI":"10.1002\/pmic.202000211","article-title":"Proteomic profiling of human uterine extracellular vesicles reveal dynamic regulation of key players of embryo implantation and fertility during menstrual cycle","volume":"21","author":"Rai","year":"2021","journal-title":"Proteomics."},{"key":"B4","doi-asserted-by":"publisher","first-page":"102258","DOI":"10.1016\/j.isci.2021.102258","article-title":"Three-dimensional understanding of the morphological complexity of the human uterine endometrium","volume":"24","author":"Yamaguchi","year":"2021","journal-title":"iScience."},{"key":"B5","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1007\/s11154-012-9223-7","article-title":"Inflammation, leukocytes and menstruation","volume":"13","author":"Evans","year":"2012","journal-title":"Rev Endocr Metab Disord."},{"key":"B6","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1093\/humupd\/6.1.16","article-title":"Endometrial leukocytes and menstruation","volume":"6","author":"Salamonsen","year":"2000","journal-title":"Hum Reprod Update."},{"key":"B7","doi-asserted-by":"publisher","first-page":"e69603","DOI":"10.7554\/eLife.69603","article-title":"Modelling the impact of decidual senescence on embryo implantation in human endometrial assembloids","volume":"10","author":"Rawlings","year":"2021","journal-title":"Elife."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1409","DOI":"10.1210\/jc.82.5.1409","article-title":"Production of endometrial matrix metalloproteinases, but not their tissue inhibitors, is modulated by progesterone withdrawal in an in vitro model for menstruation","volume":"82","author":"Salamonsen","year":"1997","journal-title":"J Clin Endocrinol Metab."},{"key":"B9","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1016\/j.mce.2011.07.042","article-title":"The endocrine and paracrine control of menstruation","volume":"358","author":"Henriet","year":"2012","journal-title":"Mol Cell Endocrinol."},{"key":"B10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/S0165-0378(99)00002-9","article-title":"Menstruation: induction by matrix metalloproteinases and inflammatory cells","volume":"44","author":"Salamonsen","year":"1999","journal-title":"J Reprod Immunol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1016\/j.ajog.2012.01.046","article-title":"The FIGO systems for nomenclature and classification of causes of abnormal uterine bleeding in the reproductive years: who needs them?","volume":"207","author":"Munro","year":"2012","journal-title":"Am J Obstet Gynecol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1016\/0002-9378(76)90013-2","article-title":"Studies on the cytodynamics of human endometrial regeneration. 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