Estrogen levels and estrogen receptors in patients with stress urinary incontinence and pelvic organ prolapse

Lang, Jinghe; Zhu, Li; Sun, Zhijing; Chen, J.

doi:10.1016/s0020-7292(02)00232-1

Cited by 94 publications

(66 citation statements)

References 6 publications

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“…The indication most closely associated with overall fracture risk, and the only one significantly associated with osteoporotic fractures, was uterine prolapse. This condition may be a marker for estrogen deficiency (36,37), although oral contraceptive use and hormone replacement therapy appear not to be protective (38,39). If so, the association with fractures previously seen with postmenopausal oophorectomy (1), which was also most evident in the subset of women with prolapse, is likely an indirect one due to confounding by the indication for the concomitant hysterectomy.…”

Section: Discussionmentioning

confidence: 99%

Influence of hysterectomy on long-term fracture risk

Melton

Achenbach

Gebhart

et al. 2007

Fertility and Sterility

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Objective-To assess long-term fracture risk following hysterectomy, with or without oophorectomy.Design-Population-based cohort study. Setting-Olmsted County, Minnesota. Patients-9258Olmsted County women who underwent hysterectomy in 1965-2002 compared to an equal number of age-and sex-matched community controls.Interventions-Observational study of the effect of hysterectomy for various indications on subsequent fractures.Main outcome measures-Fractures of any type, and at osteoporotic sites (e.g., hip, spine, and wrist) alone, as assessed by electronic review of inpatient and outpatient diagnoses in the community.Results-Compared to controls, there was a significant increase (hazard ratio [HR], 1.21; 95% CI, 1.13-1.29) in overall fracture risk among the women with hysterectomy, but osteoporotic fracture risk was not elevated (HR, 1.09; 95% CI, 0.98-1.22). Most hysterectomy indications were associated with fractures generally, albeit often not statistically significantly, but only operations for uterine prolapse were associated with osteoporotic fractures (HR, 1.33; 95% CI, 1.01-1.74). Oophorectomy was not an independent predictor of fracture risk (HR, 1.0; 95% CI, 0.98-1.15).Conclusions-Hysterectomy does not appear to pose much long-term risk for fractures, but the association of fractures with surgery for uterine prolapse deserves further attention.

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Section: Discussionmentioning

confidence: 99%

Influence of hysterectomy on long-term fracture risk

Melton

Achenbach

Gebhart

et al. 2007

Fertility and Sterility

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“…Molecular studies provide addition support for the association between ovarian hormones and POP. Serum estradiol levels and ER are significantly lower (p < 0.01) in the uterine ligaments of women who had POP than in controls without POP before menopause (8). Also, decreased levels of estrogen and progesterone receptors have been described in postmenopausal POP women compared to asymptomatic ones (p < 0.0001) (9).…”

Section: Introductionmentioning

confidence: 95%

Genes responsible for vaginal extracellular matrix metabolism are modulated by women's reproductive cycle and menopause

Shynlova

Bortolini²,

Alarab

2013

Int. braz j urol.

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Objectives: To analyze the expression of genes involved in extracellular matrix (ECM) biogenesis and remodeling in vaginal tissue of women with clinically normal pelvic floor support (defined as controls) according to the phase of menstrual cycle and postmenopausal women with and without pelvic organ prolapse (POP). Materials and Methods:This study examined the expression of matrix metalloproteinases (MMPs), their tissue inhibitors (TIMPs), and the Lysyl oxidase (LOX) family genes in the anterior vaginal wall of Caucasian women by real-time RT-PCR. Initially, mRNA expression was assessed in premenopausal controls in the secretory (group 1, n = 10) vs. proliferative (group 2, n = 8) phase of menstrual cycle. In addition, we compared premenopausal controls in the proliferative phase (group 2) vs. postmenopausal controls (group 3, n = 5). Finally, we analyzed postmenopausal controls (group 3) vs. postmenopausal women with advanced POP (group 4, n = 13). Results: According to the phase of menstrual cycle, MMP1 was significantly reduced (p = 0.003), whereas the expression of TIMP1 and LOXL4 was significantly up-regulated during proliferative phase (both p < 0.01) when compared to the secretory phase in premenopausal control women. Regarding menopausal status/ageing, all MMPs were down--regulated, while TIMP3, TIMP4 and LOXL2 were significantly up-regulated in postmenopausal control women when compared to premenopausal controls (p = 0.005, p = 0.01 and p < 0.001, correspondingly). TIMP4 and LOXL2 mRNA levels were significantly decreased in postmenopausal POP patients compared to asymptomatic postmenopausal controls (p < 0.01 for both). Conclusions: Our results indicate that ovarian cycle and age-related changes influence the expression of genes encoding proteins responsible for ECM metabolism in human vagina. Moreover, POP is associated with alteration in vaginal ECM components after menopause.

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“…The cardinal and uterosacral ligaments play a crucial role in supporting the uterus in its normal position. Serum estrogen levels and ER values have been found to be significantly lower in the uterine ligaments of pre-menopausal women with POP [20,21]. However, there was no difference in ER values among post-menopausal women with or without POP when only subtype a of ER was analyzed [20].…”

Section: Discussionmentioning

confidence: 96%

Expression of estrogen receptors in the pelvic floor of pre- and post-menopausal women presenting pelvic organ prolapse

Zbucka-Krętowska¹,

Marcus-Braun²,

Eboue³

et al. 2011

Folia Histochem Cytobiol.

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The precise role of estrogen in the pathogenesis of pelvic organ prolapse (POP) is still unclear, while the results concerning the effect of selective estrogen receptor modulators on pelvic organ prolapse are contradictory. Our aim was to test whether alteration in the expression of estrogen receptors in the pelvic floor of preand post-menopausal women is related to genital prolapse status. The mRNA levels of ERa and ERb in 60 biopsy specimens were measured. Significantly higher expression of ERa and higher ERa/ERb ratio were demonstrated in post-menopausal women compared to pre-menopausal women. Higher expression of ERa and higher ERa/ERb ratio were detected in all studied groups with POP, thus it did not reach significance in the post-menopausal group. Pre-menopausal and post-menopausal women presenting pelvic organ prolapse had no difference in the ERa expression. Our preliminary study may indicate that pelvic organ prolapse is associated with higher expression of ERa/ERb in the pelvic floor of both pre-and post-menopausal women; thus not reaching statistical significance in the post-menopausal women was probably due to the group's size. We believe that the inevitable changes in the estrogen receptor expression over women's different lifetimes may affect the risk of genital prolapse progression, and might contribute to the further search for appropriate selective estrogen receptor modulators as a treatment for women with pelvic organ prolapse. (Folia Histochemica et

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Estrogen levels and estrogen receptors in patients with stress urinary incontinence and pelvic organ prolapse

Cited by 94 publications

References 6 publications

Influence of hysterectomy on long-term fracture risk

Influence of hysterectomy on long-term fracture risk

Genes responsible for vaginal extracellular matrix metabolism are modulated by women's reproductive cycle and menopause

Expression of estrogen receptors in the pelvic floor of pre- and post-menopausal women presenting pelvic organ prolapse

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