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Does estrogen deprivation affect pelvic floor muscle contractility?

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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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Authors and Affiliations

  1. Department of Obstetrics, Gynecology & Neonatology, Sydney Medical School Nepean, The University of Sydney, 62 Derby Street, Kingswood, NSW, 2747, Australia

    Hans Peter Dietz, I. Kamisan Atan & N. Subramaniam

  2. Copernicus University, Bydgoszcz, Poland

    Maciej Socha

  3. Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia

    I. Kamisan Atan

Authors
  1. Hans Peter Dietz
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  2. Maciej Socha
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  3. I. Kamisan Atan
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  4. N. Subramaniam
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Corresponding author

Correspondence to Hans Peter Dietz.

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Conflicts of interest

HP Dietz has received unrestricted educational grants from GE Medical. M Socha has no conflict of interest to declare. All other authors claim no conflict of interest.

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Dietz, H.P., Socha, M., Atan, I.K. et al. Does estrogen deprivation affect pelvic floor muscle contractility?. Int Urogynecol J 31, 191–196 (2020). https://doi.org/10.1007/s00192-019-03909-w

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  • DOI: https://doi.org/10.1007/s00192-019-03909-w

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