Internal medicine

Neuroscience

Menstrual cycle

Biology

Cancer

Adenomyosis

Endometrial cancer

Endometriosis

Endometrium

Gynecology

Organoid

Hormone

Medicine

Nature Reviews Endocrinology

Each month during a woman’s reproductive years, the endometrium undergoes vast changes to prepare for a potential pregnancy. Diseases of the endometrium arise for numerous reasons, many of which remain unknown. These endometrial diseases, including endometriosis, adenomyosis, endometrial cancer and Asherman syndrome, affect many women, with an overall lack of efficient or permanent treatment solutions. The challenge lies in understanding the complexity of the endometrium and the extensive changes, orchestrated by ovarian hormones, that occur in multiple cell types over the period of the menstrual cycle. Appropriate model systems that closely mimic the architecture and function of the endometrium and its diseases are needed. The emergence of organoid technology using human cells is enabling a revolution in modelling the endometrium in vitro. The goal of this Review is to provide a focused reference for new models to study the diseases of the endometrium. We provide perspectives on the power of new and emerging models, from organoids to microfluidics, which have opened up a new frontier for studying endometrial diseases. Endometrial diseases affect many women yet often have unclear pathogenesis and no definitive treatment. This Review assesses the current systems for modelling endometrial diseases in vitro and outlines future directions for these model systems.

Strategies for modelling endometrial diseases