title: Ultrasonographic and doppler velocimetric evaluation of the levator ani muscle according to the hormonal status.
abstract: OBJECTIVE
  We aimed to study the cross-sectional area of levator ani muscle and the doppler velocimetric parameters of vessels its in premenopausal and postmenopausal women.
  
  
  METHODS
  Sixty-four patients, divided into 3 groups, were assessed: group I (20 women-average age 28 years) premenopausal and nulliparous (control); group II (24 women-average age 38 years, vaginal delivery 1-4) premenopausal with vaginal deliveries; group III (20 women-average age 55 years, parity 0-4) postmenopausal without hormonal therapy. Doppler velocimetry of levator ani muscle vessels through resistance and pulsatility indices was used and the means of the groups compared by adjusting the weighed variance model with multiple comparisons, according to Tukey's method. Similarly, we measured the cross-sectional area of the muscle using ultrasonography.
  
  
  RESULTS
  There was a significant increase in resistance and pulsatility indices in postmenopausal patients as compared to the other two groups. We also observed a significant decrease in the cross-sectional area of the muscle of postmenopausal patients when compared to those in premenopausal.
  
  
  CONCLUSIONS
  The obtained results allow us to conclude that levator ani muscle vascularization significantly decreases after menopause (age and/or hipoestrogenism) and that it can be assumed that vaginal delivery does not promote long-term alterations in levator ani muscle vascularization. We also observed a significant decrease in the cross-sectional area of the muscle in postmenopausal women when compared to those in premenopausal.
authors.affiliation: Department of Gynecology, Federal University of São Paulo, São Paulo, Brazil. alberto.noguti@terra.com.br
authors.forename: Alberto S
authors.initials: AS
authors.lastname: Noguti
authors.forename: Zsuzsanna I K
authors.initials: ZI
authors.lastname: Jarmy-Di Bella
authors.forename: Emerson
authors.initials: E
authors.lastname: de Oliveira
authors.forename: Rodrigo A
authors.initials: RA
authors.lastname: Castro
authors.forename: Geraldo R
authors.initials: GR
authors.lastname: Lima
authors.forename: Edmund Chada
authors.initials: EC
authors.lastname: Baracat
authors.forename: Marair G F
authors.initials: MG
authors.lastname: Sartori
authors.forename: Manoel J B C
authors.initials: MJ
authors.lastname: Girão