title: Effects of ovarian failure on submucosal collagen and blood vessels of the anal canal in postmenopausal women.
abstract: BACKGROUND
  Estrogen and progesterone receptors are expressed in the anal canal. Fecal control deteriorates after menopause. This phenomenon is related to decreased circulating levels of estrogen and progesterone due to ovarian failure at menopause.
  
  
  OBJECTIVE
  To study the effects of estrogen and progesterone on inflammatory cells, submucosal collagen fibers, and vascular plexus of the anal canal of postmenopausal women.
  
  
  METHODS
  Experiments were performed on samples of anorectal tissue obtained from 40 women, 19 menstruating (group I), and 21 postmenopausal women (group II). Investigations included immunohistochemistry of estrogen and progesterone receptors and CD34.
  
  
  RESULTS
  In negative estrogen receptors (ER) and progesterone receptors (PR), inflammatory cells, submucosal blood vessels, collagen type I were nonsignificantly changed in postmenopausal women relative to menstruating women (P > 0.05) whereas, in positive ER and PR, inflammatory cells and collagen I were significantly increased and submucosal blood vessels were significantly decreased in postmenopausal women relative to menstruating women (P < 0.05).
  
  
  CONCLUSIONS
  Estrogen and progesterone, in menstruating women, produce beneficial effects by decreasing incidence of inflammation and increasing anal canal submucosal blood vessels number and collagen types I, thus both hormones have a positive effect on anal compliance and pressure.
authors.affiliation: Department of General and Colorectal Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt. hosamelbanna@hotmail.com
authors.forename: Hosam Ghazy
authors.initials: HG
authors.lastname: Elbanna
authors.forename: Amr Medhat
authors.initials: AM
authors.lastname: Abbas
authors.forename: Khaled
authors.initials: K
authors.lastname: Zalata
authors.forename: Mohamed
authors.initials: M
authors.lastname: Farid
authors.forename: Wageh
authors.initials: W
authors.lastname: Ghanum
authors.forename: Mohamed
authors.initials: M
authors.lastname: Youssef
authors.forename: Waleed Mohamed
authors.initials: WM
authors.lastname: Thabet
authors.forename: Saleh
authors.initials: S
authors.lastname: El Awady
authors.forename: Mohamed H Abd
authors.initials: MH
authors.lastname: El-Sattar
mesh_terms: D001003:Anal Canal / Q000098:blood supply* / Q000378:metabolism* / Q000648:ultrastructure; D001808:Blood Vessels; D024042:Collagen Type I / Q000032:analysis*; D004967:Estrogens; D005260:Female; D006801:Humans; D007249:Inflammation; D010053:Ovary / Q000503:physiopathology*; D017698:Postmenopause / Q000502:physiology*; D011374:Progesterone; D011960:Receptors, Estrogen / Q000032:analysis; D011980:Receptors, Progesterone / Q000032:analysis
chemical_list: D024042:Collagen Type I; D004967:Estrogens; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D011374:Progesterone