Abstract
ObjectiveTo examine the relationship between endogenous sex steroids and various condition-specific quality of life domains in postmenopausal women with pelvic floor disorders. We hypothesized that woman with lowest androgen and estradiol concentrations would report worse scores of quality of life domains.MethodsForty-six women with pelvic organ prolapse (POP) and 47 cases with stress urinary incontinence (SUI) answered the validated pelvic floor questionnaire and underwent serum sex steroid measurement. A multivariate logistic regression model was used to determine the association between subjective outcome parameters and serum hormonal levels after adjusting for confounders.ResultsUnivariate analysis revealed a strong inverse correlation between serum estradiol level (E2) and prolapse domain score (correlation coefficient = 0.005) as well as a significant positive correlation between SHBG level and prolapse domain score (correlation coefficient = 0.019) in cases with POP. Furthermore, the sex domain score showed a significant negative correlation with the androstendion (correlation coefficient = 0.020), DHEAS (correlation coefficient = 0.046) and testosterone level (correlation coefficient = 0.032) in the POP group. In the multivariate model, high serum SHBG (CI: 0.007–0.046) remained independently associated with worse scores in the prolapse domain and low serum DHEAS (CI: − 0.989 to 1.320) persisted as a significant predictor for a worse score in the sex domain. Regarding SUI cases, no association was noted between serum hormonal levels and quality of life related pelvic floor domains (correlation coefficient > 0.05).ConclusionOur results suggest that pelvic floor related quality of life might also be affected by endogenous sex steroids in POP, but not in SUI cases.
Highlights
Pelvic floor disorders (PFD) are common gynecologic complaints that adversely affect the quality of life of many women because of their impact on medical, social, emotional, and sexual well-being [1]
Ninety-seven women in all gave consent to participate in this study, 93 of whom (96%) were included after returning an evaluable complete survey [46 with symptomatic pelvic organ prolapse (POP) ≥ stage 2 and 47 with verified stress urinary incontinence (SUI)]
We have examined the relationship between circulating sex steroids and various self-reported condition-specific pelvic floor domains in postmenopausal women with SUI or symptomatic POP
Summary
Pelvic floor disorders (PFD) are common gynecologic complaints that adversely affect the quality of life of many women because of their impact on medical, social, emotional, and sexual well-being [1]. Validated questionnaires and scales play an important role in identifying symptoms of a disease, helping clinicians assess patient’s quality of life [2]. The levels of sex steroids, estrogens and androgens, change markedly during menopause [4] and the risk to develop a pelvic floor disorder of any kind increases significantly in postmenopause. The prevalence of prolapse increases in the postmenopausal period, suggesting that a hypoestrogenic state is an important contributing factor [8, 9] These disorders can have a detrimental impact on health-related quality of life and women’s sexual well-being [10].
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