Effects of ovarian failure on submucosal collagen and blood vessels of the anal canal in postmenopausal women.
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.
Elbanna
Hosam Ghazy
HG
Department of General and Colorectal Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt. hosamelbanna@hotmail.com
Abbas
Amr Medhat
AM
Zalata
Khaled
K
Farid
Mohamed
M
Ghanum
Wageh
W
Youssef
Mohamed
M
Thabet
Waleed Mohamed
WM
El Awady
Saleh
S
El-Sattar
Mohamed H Abd
MH
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
D024042:Collagen Type I; D004967:Estrogens; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D011374:Progesterone