Does estrogen deprivation affect pelvic floor muscle contractility?

Hans Peter Dietz, Maciej Socha, Ixora Kamisan @ Atan, N. Subramaniam

Research output: Contribution to journalArticle

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Abstract

Introduction and hypothesis: Pelvic floor muscle (PFM) function plays a role in pelvic organ support, and estrogen deprivation is commonly seen as a risk factor for pelvic floor dysfunction. This study investigated the association between estrogen deprivation and PFM contractility. Methods: This was a retrospective study on women attending a tertiary urogynecological unit. The assessment included an interview, POPQ assessment, Modified Oxford Scale (MOS) score, and 4D translabial ultrasound (US) on PFM contraction (PMFC). Hormonal status and details on hormone replacement therapy (HRT) were recorded. Corrected menopausal age was defined as the duration of systemic estrogen deprivation. Offline analysis of stored US volumes was performed to measure the reduction in anteroposterior hiatal diameter and bladder neck elevation on PFMC at a later date. Results: Seven hundred thirty-nine women were seen during the study period. Fifty-three were excluded for missing data, leaving 686. Mean age was 56 (17–89, SD 13.3) years; average BMI was 29 (16–66, SD 6.6) kg/m²; 60.6% (n = 416) were menopausal at a mean duration of 16 (1–56, SD 10.2) years. Forty-nine (7.1%) were currently on systemic HRT, while 104 (15.2%) had used it previously. Mean corrected menopausal age (menopausal age - systemic HRT duration) was 7.4 (0–56, SD 10.0) years. Current local estrogen use ≥ 3 months was reported by 31 (4.5%). Mean PFM contractility measured by MOS was 2 (0–5, SD 1.1,). On multivariate analysis there was no association between menopausal age and PFM contractility. Conclusions: Estrogen deprivation may not be an independent predictor of pelvic floor muscle contractility.

Original languageEnglish
JournalInternational Urogynecology Journal
DOIs
Publication statusPublished - 1 Jan 2019

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Pelvic Floor
Estrogens
Muscles
Hormone Replacement Therapy
Muscle Contraction
Urinary Bladder
Multivariate Analysis
Retrospective Studies
Interviews

Keywords

  • Estrogen deprivation
  • Menopause
  • Pelvic floor function
  • Pelvic organ prolapse
  • Translabial ultrasound

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Urology

Cite this

Does estrogen deprivation affect pelvic floor muscle contractility? / Dietz, Hans Peter; Socha, Maciej; Kamisan @ Atan, Ixora; Subramaniam, N.

In: International Urogynecology Journal, 01.01.2019.

Research output: Contribution to journalArticle

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abstract = "Introduction and hypothesis: Pelvic floor muscle (PFM) function plays a role in pelvic organ support, and estrogen deprivation is commonly seen as a risk factor for pelvic floor dysfunction. This study investigated the association between estrogen deprivation and PFM contractility. Methods: This was a retrospective study on women attending a tertiary urogynecological unit. The assessment included an interview, POPQ assessment, Modified Oxford Scale (MOS) score, and 4D translabial ultrasound (US) on PFM contraction (PMFC). Hormonal status and details on hormone replacement therapy (HRT) were recorded. Corrected menopausal age was defined as the duration of systemic estrogen deprivation. Offline analysis of stored US volumes was performed to measure the reduction in anteroposterior hiatal diameter and bladder neck elevation on PFMC at a later date. Results: Seven hundred thirty-nine women were seen during the study period. Fifty-three were excluded for missing data, leaving 686. Mean age was 56 (17–89, SD 13.3) years; average BMI was 29 (16–66, SD 6.6) kg/m²; 60.6{\%} (n = 416) were menopausal at a mean duration of 16 (1–56, SD 10.2) years. Forty-nine (7.1{\%}) were currently on systemic HRT, while 104 (15.2{\%}) had used it previously. Mean corrected menopausal age (menopausal age - systemic HRT duration) was 7.4 (0–56, SD 10.0) years. Current local estrogen use ≥ 3 months was reported by 31 (4.5{\%}). Mean PFM contractility measured by MOS was 2 (0–5, SD 1.1,). On multivariate analysis there was no association between menopausal age and PFM contractility. Conclusions: Estrogen deprivation may not be an independent predictor of pelvic floor muscle contractility.",
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