Critchley group

Our research specifically examines local mechanisms within the womb-lining (endometrium) involved in menstruation and abnormal uterine bleeding (AUB). Menstruation displays features of an inflammatory event and is a physiological event of repeated "tissue injury and repair" We study the cascade of events that occur in cells of the endometrium and that lead to its shedding. These events are triggered by withdrawal of the hormone, progesterone. This occurs at the end of each monthly cycle prior to a period. We are interested in the complex dialogue between circulating steroid hormones and the many different cell types, including immune cells that constitute the endometrium.

We also study factors that switch on production of molecules involved in blood vessel growth and repair in the endometrium; both necessary events to prepare for the next menstrual cycle. If we can understand how the womb heals itself without scarring as women go through their menstrual cycles we hope we will contribute valuable information relevant to inflammation and scarring throughout the body. If these events are disturbed then abnormal menstrual bleeding may be the result. We are therefore studying endometrial samples collected from women attending with menstrual complaints including women with uterine fibroids. We hope that information about the molecular and cellular pathways involved in menstruation and its disorders will help identify new targets for treatment, especially if these treatments could be delivered directly to the uterus.

Development of novel medical treatments for management of debilitating menstrual complaints aims to enable women to avoid surgery and thereby preserve uterine function and fertility potential.

A further under-recognised issue we are intent on addressing is the related health impact of AUB and HMB, of iron deficiency (ID) and ID anaemia (IDA).

Image

• Ending the taboo on periods and period problems. Critchley HOD, Roberts I, Murji A, Lavin M, Regan L, Georgieff MK, Munro MG. Nat Med. 2025 Aug;31(8):2470-2472. doi: 10.1038/s41591-025-03778-5. PMID: 40579549
• Luteal phase oral dexamethasone administration alters endometrial steroid milieu. Homer NZM, Nicol M, Madhra M, Naredo-Gonzalez G, Laforest S, Slayden OD, Hillier SG, Walker BR, Warner P, Andrew R, Critchley HOD. Endocr Connect. 2025 May 1;14(5):e240638. doi: 10.1530/EC-24-0638. PMID: 40132139
• Feasibility study of the application of magnetic resonance elastography to diagnose uterine adenomyosis. Jain V, Hojo E, McKillop G, Oniscu A, Le Y, Chen J, Ehman R, Roberts N, Critchley HOD. F S Sci. 2025 May;6(2):242-251. doi: 10.1016/j.xfss.2025.03.003. PMID: 40147715
• Active chromatin marks and up-regulation of FOXC1 in uterine epithelial cells demarcate the onset of reproductive decline in aging females. Tsolova AO, Lea G, Jadli AS, Mastrokolias A, Narang A, Krala A, Radford BN, Hanna CW, Kelsey GD, Critchley HOD, Dean W, Hemberger M. NAR Mol Med. 2025 Aug 13;2(3):ugaf031. doi: 10.1093/narmme/ugaf031. PMID: 40922722
• Ulipristal acetate versus levonorgestrel-releasing intrauterine system for heavy menstrual bleeding (UCON): a randomised controlled phase III trial.  Whitaker, L. H. R., Middleton, L. J., Daniels, J. P., Williams, A. R. W., Priest, L., Odedra, S., Cheed, V., Stubbs, C. E., Clark, T. J., Lumsden, M. A., Hapangama, D. K., Bhattacharya, S., Smith, P. P., Nicholls, E. P., Roberts, N., Semple, S. I., Saraswat, L., Walker, J., Chodankar, R. R., Critchley, H. O. D., UCON Collaborative (2023). EClinicalMedicine, 60, 101995. https://doi.org/10.1016/j.eclinm.2023.101995 PMID: 37251622
• Our path from abnormal uterine bleeding and iron deficiency to impaired fetal development: A long and winding road.  Munro, M. G., & Critchley, H. O. D. (2023). Int J Gynaecol Obstet. 2023 Aug:162 Suppl 2:3-6. doi: 10.1002/ijgo.14942 PMID: 37538012
• Uterine bleeding: how understanding endometrial physiology underpins menstrual health. Jain, V., Chodankar, R. R., Maybin, J. A., & Critchley, H. O. D. (2022). Nature Reviews Endocrinology, 18(5), 290–308. https://doi.org/10.1038/s41574-021-00629-4 PMID: 35136207
• Menstruation should not be overlooked in control of anaemia. Critchley, H. O. D., Munro, M. G., Shakur-Still, H., & Roberts, I. (2021). Lancet (London, England), 397(10268), 26. https://doi.org/10.1016/S0140-6736(20)32718-5 PMID: 33388103
• Treatment of Uterine Fibroid Symptoms with Relugolix Combination Therapy. Ayman Al-Hendy, Andrea S Lukes, Alfred N Poindexter 3rd, Roberta Venturella, Claudio Villarroel, Hilary O D Critchley, Yulan Li, Laura McKain, Juan C Arjona Ferreira, Andria G M Langenberg, Rachel B Wagman, Elizabeth A Stewart. N Engl J Med. 2021 Feb 18;384(7):630-642. doi: 10.1056/NEJMoa2008283. PMID: 33596357
• Low dose dexamethasone as treatment for women with heavy menstrual bleeding: A response-adaptive randomised placebo-controlled dose-finding parallel group trial (DexFEM). Warner, P., Whitaker, L. H. R., Parker, R. A., Weir, C. J., Douglas, A., Hansen, C. H., Madhra, M., Hillier, S. G., Saunders, P. T. K., Iredale, J. P., Semple, S., Slayden, O. D., Walker, B. R., & Critchley, H. O. D. (2021). EBioMedicine, 69, 103434.  https://doi.org/10.1016/j.ebiom.2021.103434. PMID: 34218053
• Menstruation: science and society. Critchley, H. O. D., Babayev, E., Bulun, S. E., Clark, S., Garcia-Grau, I., Gregersen, P. K., Kilcoyne, A., Kim, J. J., Lavender, M., Marsh, E. E., Matteson, K. A., Maybin, J. A., Metz, C. N., Moreno, I., Silk, K., Sommer, M., Simon, C., Tariyal, R., Taylor, H. S., Wagner, G. P., … Griffith, L. G. (2020). Am J Obstet Gynecol. 2020 Nov;223(5):624-664. doi: 10.1016/j.ajog.2020.06.004. PMID: 32707266
• Physiology of the Endometrium and Regulation of Menstruation. Critchley, H. O. D., Maybin, J. A., Armstrong, G. M., & Williams, A. R. W. (2020). Physiological Reviews, 100(3), 1149- 1179.  https://doi.org/10.1152/physrev.00031.2019 PMID: 32031903
• The two FIGO systems for normal and abnormal uterine bleeding symptoms and classification of causes of abnormal uterine bleeding in the reproductive years: 2018 revisions. Munro, M. G., Critchley, H. O. D., Fraser, I. S., & FIGO Menstrual Disorders Committee (2018). Int J Gynaecol Obstet. 2018 Dec;143(3):393-408. doi: 10.1002/ijgo.12666. PMID: 30198563

• Determining the endometrial phenotype of women with abnormal uterine bleeding (AUB).
• Mechanisms underpinning AUB and heavy menstrual bleeding (HMB) and development of physiomimetic models
• Unravelling the causes of declining uterine function with age
• Understanding health related impacts of AUB and HMB: iron deficiency (ID) and ID anaemia
• Mechanisms of action of selective progesterone receptor modulators (SPRMs) on the endometrium and uterus.
• Novel magnetic resonance imaging (MRI) of uterine morphology in women with AUB.

• DexFEM (MRC DCS/ DPFS funding) DOI: 10.1016/j.ebiom.2021.103434

Low dose dexamethasone as treatment for women with heavy menstrual bleeding: A response-adaptive randomised placebo-controlled dose-finding parallel group trial Dexamethasone for Excessive Menstruation (DexFEM). 

• UCON (NIHR/MRC EME programme funding) DOI: 10.1016/j.eclinm.2023.101995

Dr Varsha Jain, Senior Clinical Research Fellow

Prof Alistair Williams, Professor Emeritus (Pathology)

Dr Shaden Melhem, Postdoctoral Research Fellow

Dr Pia Wahi-Singh,  recent Academic Foundation Doctor

Local

• Profesor Ruth Andrew
• Professor Neil Carragher
• Dr Ooi Thye Chong
• Dr Douglas Gibson
• Professor David Hay
• Dr Natalie Homer
• Professor Andrew Horne
• Dr Robert Illingworth
• Dr Jackie Maybin
• Professor Neil Roberts
• Professor Philippa Saunders
• Dr Pamela Warner
• Dr Lucy Whitaker
• Professor Emeritus Alistair Williams

National

• Professor Justin Clark (Birmingham)
• Professor Dharani Hapangama (Liverpool)
• Professor Gavin Kelsey (Babraham Institute, Cambridge)
• Professor Mary Ann Lumsden (Glasgow)
• Professor Ashley Moffett (Cambridge)
• Professor Ian Roberts & Dr Sima Berendes (LSHTM, London)
• Dr Lucky Saraswat (Aberdeen)

International

• Professor Linda Griffith (Massachusetts Institute of Technology, USA)
• Professor Sun-Wei Guo (Fudan University, Shanghai, China)
• Professor Myriam Hemberger and Professor Wendy Dean (University of Calgary, Canada)
• Dr Whitney Henry (Massachusetts Institute of Technology, USA)
• Professor Doug Lauffenburger (Massachusetts Institute of Technology, USA)
• Professor Mac Munro (Los Angeles, USA)
• Professor Felice Petraglia (Florence, Italy)
• Professor Peter Rogers (Melbourne, Australia)
• Professor Carlos Simon (Valencia, Spain)
• Dr Ov Slayden (Portland, USA)
• Dr Margherita Turco (Basel, Switzerland)
• Dr Steve Yellon (Loma Linda University, USA)

• Wellbeing of Women Research Advisory Committee (RAC) Chair from 2024-
• Cambridge Reproduction, Member of External Advisory Board from 2025-
• Society for Reproductive Investigation (SRI) Chair, Development Committee and Foundation (DCaF) from 2025-
• Immediate Past Chair 2023-2025: International Federation of Gynecology and Obstetrics (FIGO) Committee for Menstrual Disorders and Related Health Impacts (MDRHI); Chair 2021-2023
• Centre for Trophoblast Research (CTR), Cambridge – Immediate Past Chair CTR Scientific Advisory Board Chair, 2021-2024; CTR Scientific Advisory Board Member, 2014-2021
• Editorial Board Membership: Physiological Reviews (from 2019 - ) Associated Editor

2026: Professor Critchley named a "Giant in Obstetrics and Gynecology" by the American Journal of Obstetrics and Gynecology in recognition for her pioneering contributions to the field. Read here

2021: Elected as an International Member to the US National Academy of Medicine (NAM)

2021: Professor Critchley recipient of the Society for Reproductive Investigation (SRI) DeCherney Society Lifetime Distinguished Service Award: recognises an individual who has made outstanding contributions to the Society for Reproductive Investigation and significant contributions to the field of reproductive medicine and women's health.

2021: Professor Critchley recipient of RCOG Annual Academic Award. This prize has been awarded by the RCOG in recognition of her distinguished service to academic obstetrics and gynaecology, in particular her outstanding contributions to scientific discovery, pre-clinical and clinical research, academic education and training.

2020: The SRF (Society for Reproduction and Fertility) Distinguished Scientist Anne McLaren Award 2020 has been awarded to Professor Hilary O D Critchley, MRC Centre for Reproductive Health, The University of Edinburgh, for her outstanding contributions in the field of women's reproductive biology.

2019: Featured in Celebrating Women in Science in Scotland Exhibition, Royal Society of Edinburgh – an “exhibition celebrating some of Scotland's finest female scientists”. https://www.rse.org.uk/women-science-exhibition/

2019: Exemplar of international recognition: NIH, Bethesda, USA: (UK invited participant) meeting: Menstruation, Science and Society (goal to discuss promising new discoveries and avenues of research surrounding menstruation).

2017: University of Edinburgh awarded Queen's Anniversary Prize for "Clinical innovations to respond to major unmet needs in women's health" submitted on behalf of the University of Edinburgh by JE Norman and HOD Critchley

2015: Awarded Lady Margaret MacLellan Award, Tenovus Scotland for contributions to 'Women's Health'.

2008: Awarded The British Fertility Society Lectureship: The H S Jacobs President's Lecture: awardee has made an outstanding contribution to the field of reproductive medicine and commands an international reputation.

2008: Awarded British Endocrine Societies: Society for Endocrinology Medal & Lecture: awardee is an endocrinologist working in the UK in recognition of outstanding studies.

Recently Professor Critchley was interviewed by 'Faculti' - Academic streaming platform, which is covering the latest research, analysis and scholarship world-wide. Professor Critchley talked on the topic: Menstruation: Science and Society, on women's health concerns that are underrepresented and lacking understanding of basic uterine and menstrual physiology.  She discussed the research gaps; opportunities in menstrual science and education of women's health.

View the interview on Faculti