Hormones restore biomechanical properties of the vagina and supportive tissues after surgical menopause in young rats

Moalli, Pamela; Debes, K; Meyn, Leslie A.; Howden, N; Abramowitch, Steven D.

doi:10.1016/j.ajog.2008.01.042

Cited by 40 publications

(45 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We have demonstrated that there is a genetic predisposition for developing POP independent of menopause and leuprolide administration which is associated with hypoestrogenism. Current in vitro and animal studies have shown that estrogen has positive effects on the ECM 15–17, 20 and others have shown that hypoestrogenism is associated with deterioration of the ECM and development of POP 5–7,19. The Women’s Health Initiative demonstrated that conjugated equine estrogen alone and conjugated equine estrogen with medroxyprogestesrone increased the risk of urinary incontinence among continent women and worsened the characteristics of urinary incontinence in symptomatic women after 1 year of treatment 37.…”

Section: Discussionmentioning

confidence: 99%

“…In postmenopausal women, collagen subtypes are altered in the endopelvic fascia, and hormones have been shown to restore the biomechanical properties of the vagina and supportive tissues after surgical menopause in young rats 19,20. Therefore, the influence of menopause on the ECM has been studied looking to determine pathways that estrogen may be involved in the development of prolapse.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Diminished vaginal HOXA13 expression in women with pelvic organ prolapse

Connell

Guess²,

Tate³

et al. 2009

Menopause

View full text Add to dashboard Cite

Objective Homeobox genes are transcriptional regulators that orchestrate embryonic development. The HOXA13 gene is responsible for the development of the vagina and regulates extracellular matrix (ECM) constituents. We hypothesized that vaginal expression of HOXA13 may be decreased in women with pelvic organ prolapse (POP) and sought to determine if hypoestrogenism affects its expression. Design Biopsy specimens were obtained from the anterior apex of the vagina from women with and without POP. Immunohistochemistry and real time PCR were used to determine HOXA13 expression in premenopausal controls, premenopausal women receiving leuprolide acetate, and in premenopausal and postmenopausal women with POP. Results HOXA13 was expressed in all specimens. HOXA13 expression was 14 fold lower in premenopausal women with prolapse than premenopausal controls (P<0.001). In both POP groups, HOXA13 expression was lower than the leuprolide group (p=<0.001). There were no differences in HOXA13 expression between premenopausal controls and specimens from women treated with leuprolide acetate (p= 1.0) or between the premenopausal and postmenopausal POP group (p= 1.0). Conclusion Vaginal HOXA13 expression is diminished in women with POP compared to women with normal support. In women with POP, expression of HOXA13 was not affected by menopause. Expression of HOXA13 was also not affected by exposure to leuprolide acetate, suggesting that estrogen and HOXA13 work through separate pathways in the ECM metabolism of the vagina. Understanding genetic predispositions to developing POP may identify younger patients at risk who may benefit from preventative strategies such as weight loss or smoking cessation and not necessarily from estrogen therapy.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Diminished vaginal HOXA13 expression in women with pelvic organ prolapse

Connell

Guess²,

Tate³

et al. 2009

Menopause

View full text Add to dashboard Cite

show abstract

“…Based on this study, five animals per group would be required to achieve statistical significance with a power of at least 80% [6]. Results are represented as mean±SD.…”

Section: Methodsmentioning

confidence: 99%

Pregnancy- and delivery-induced biomechanical changes in rat vagina persist postpartum

et al. 2010

View full text Add to dashboard Cite

show abstract

“…Studies from our laboratory have suggested that, while parity sets the stage, hormones play a role by protecting pelvic soft tissue supportive structures from degradation by matrix metalloproteinases (MMPs). This was demonstrated in the rodent model by showing that hormone therapy (HT) or an MMP inhibitor equally obviated the decline in mechanical integrity following surgical menopause (ovariectomy) [5]. Using vaginal fibroblasts subjected to cyclic stretching from human subjects, this mechanism was further elucidated by showing an increase in active MMP in the presence of stretch and suppression of this response in the presence of hormones [6, 7].…”

Section: Introductionmentioning

confidence: 99%

Changes in the rheological behavior of the vagina in women with pelvic organ prolapse

et al. 2012

View full text Add to dashboard Cite

Introduction and hypothesis Pelvic organ prolapse is a common condition impacting the quality of life of millions of women worldwide. Although vaginal estrogen is widely used in women with prolapse, little is known regarding estrogen’s benefits on the biomechanical properties of vaginal tissue. Here, we aimed to examine the effect of prolapse on the biomechanical properties of the vagina and determine alterations in vaginal mechanics in the presence and absence of hormone therapy (HT). Methods We characterized the viscoelastic properties of vaginal biopsies from age-matched premenopausal women without (n=12) and with prolapse (n=8) and postmenopausal women with prolapse on (n=18) and off HT (n=9). Utilizing a single-lap shear testing protocol, full-thickness anterior vaginal biopsies were subjected to ±10 % shear strain over a range of frequencies (1–90 Hz). This applied energy is either dissipated (viscous) or stored (elastic) as a function of frequency due to compositional or structural differences in the tissue. Results Prolapsed tissue was more stiff (higher complex modulus) under shear deformation resulting from increases in both elastic (elastic modulus) and viscous (loss modulus) contributions, with non-prolapsed premenopausal women being the least stiff. Postmenopausal women with prolapse currently on HT were the most stiff of all the groups. Conclusions These data suggest that prolapsed tissue has an increased elastic contribution likely resulting from changes in biochemical constituents, and hormones increase the viscous contribution of prolapsed tissue. Overall, this study design characterized the viscoelastic properties of vaginal biopsies and may be utilized to conduct longitudinal studies to better understand the mechanisms of prolapse development and progression.

show abstract

Hormones restore biomechanical properties of the vagina and supportive tissues after surgical menopause in young rats

Cited by 40 publications

References 25 publications

Diminished vaginal HOXA13 expression in women with pelvic organ prolapse

Diminished vaginal HOXA13 expression in women with pelvic organ prolapse

Pregnancy- and delivery-induced biomechanical changes in rat vagina persist postpartum

Changes in the rheological behavior of the vagina in women with pelvic organ prolapse

Contact Info

Product

Resources

About