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Eur J Obstet Gynecol Reprod Biol. 2017 Mar;210:177-181. doi: 10.1016/j.ejogrb.2016.12.027. Epub 2016 Dec 26.

Pelvic organ prolapse and endogenous circulating sex steroids in postmenopausal women: A case control-study.

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Department of General Gynecology and Gynecologic Oncology, Medical University of Vienna, Austria. Electronic address:
Department of General Gynecology and Gynecologic Oncology, Medical University of Vienna, Austria.
Department of Anesthesiology, Medical University of Vienna, Austria; Outcomes Research Consortium, Cleveland, OH, USA.



We compared sex steroid levels of postmenopausal patients with symptomatic pelvic organ prolapse (POP) with postmenopausal matched patients without any sign of POP. Furthermore, we evaluated a possible relationship between sex steroid levels and various urogynecologic parameters in cases with POP. Main outcome of interest were differences in circulating estradiol levels between the two groups.


We conducted a case-control study and 46 postmenopausal women with symptomatic POP≥stage 2 were matched 1:1 with 46 urogynecologic healthy women. Blood samples were drawn from all patients for assessment for estradiol (E2), Follicle-stimulating hormone (FSH), Luteinizing hormone (LH), testosterone (T), androstendion (AEON), dehydroepiandrosterone sulphate (DHEAS) and sex hormone binding globulin (SHBG) with an Electrochemiluminescence immunoassay.


Our study failed to show any statistically significant differences in sex steroid levels between women with and without POP (p>0.05). However, serum concentration of E2 (p<0,0001), free testosterone (p=0,034) and DHEAS (p=0,024) was statistically significant lower in patients with severe prolapse stage. Serum levels of E2 were statistically significant higher in cases with moderate-strong Oxford Grading Scale (p<0,0001). Low circulating E2 (p=0,019) as well as menopausal age (p=0,022) remained independent risk factors for POP in multiple logistic regression analysis.


The significant low hormonal levels in cases with high POP-Q stage as well as the significant higher estradiol levels in patients with strong Oxford Grading Scale may indicate that endogenous circulating sex steroids might have a potential role in the severity and progression of POP.


Association with urogynecologic parameters; Endogenous sex steroid levels; Pelvic organ prolapse

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