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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.

Author information

1
Department of General Gynecology and Gynecologic Oncology, Medical University of Vienna, Austria. Electronic address: Barbara.Bodner-Adler@meduniwien.ac.at.
2
Department of General Gynecology and Gynecologic Oncology, Medical University of Vienna, Austria.
3
Department of Anesthesiology, Medical University of Vienna, Austria; Outcomes Research Consortium, Cleveland, OH, USA.

Abstract

OBJECTIVE:

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.

STUDY DESIGN:

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.

RESULTS:

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.

CONCLUSION:

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.

KEYWORDS:

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

PMID:
28056433
DOI:
10.1016/j.ejogrb.2016.12.027
[Indexed for MEDLINE]

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