Estrogen receptor expression and vessel density in the vagina wall in postmenopausal women with prolapse.
After menopause, critically estrogen low levels result in modifications in vaginal wall. This cross-sectional study aims to determine whether there is a change in the number of vessels in the lamina propria of the vagina after menopause in parallel to the ER-alpha expression on the vaginal wall. Twelve women who underwent a genital surgery for genital prolapse up to grade II were selected. They were divided into two groups: a premenopausal group (PG) consisting of six women who were 18-40 years old with FSH levels =12 mIU/ml and regular cycles, and a menopausal group (MG) consisting of six women at least one year after menopause who were <65 years old with FSH levels =40 mIU/ml. Slides were stained for ER-alpha immunohistochemistry, and an endothelial cell marker CD3 was used to label vessels which were identified by using a system for morphometry. The number of vessels was significantly higher in the PG than in the MG both on the anterior wall (PG: 1.055 ± 145.8 vessels/mm(2), MG: 346.6 ± 209.9 vessels/mm(2), p<0.0001) and on the posterior wall (PG: 1064 ± 303.3 vessels/mm(2), MG: 348.6 ± 167.3 vessels/mm(2), p=0.0005). The ER-alpha score was significantly higher in the PG than the score for the MG on both the anterior and posterior walls (PG: 6.0 ± 0.52, MG: 2.5 ± 0.89, p=0.007; PG: 5.8 ± 0.79, MG: 2.7 ± 0.95, p=0.03, respectively). There was a positive correlation between the ER-alpha score and the vessel concentration on the anterior (r=0.6656, p=0.018) and posterior (r=0.6738, p=0.016) vaginal walls. Age was strongly negatively correlated with vessel concentration on the vaginal walls (respectively r=-0.9033, p<0.0001, r=-0.7440, p=0.0055). Therefore, postmenopausal women with genital prolapse have a smaller number of vessels on the vaginal wall compared to normoestrogenic controls with the same pathological condition. Hypoestrogenism and advancing age are factors that are associated to these changes.
Sexual Medicine Service of Human Reproduction Sector, Department of Gynaecology and Obstetrics of the Faculty of Medicine of Ribeirão Preto, São Paulo University, Ribeirão Preto, SP, Brazil. Electronic address: lucialvess@yahoo.com.br.
Lúcia Alves da Silva
LA
Lara
Department of Pathology of the Faculty of Medicine of Ribeirão Preto, São Paulo University, Ribeirão Preto, SP, Brazil. Electronic address: ars@fmrp.usp.br.
Alfredo
A
Ribeiro da Silva
Sexual Medicine Service of Human Reproduction Sector, Department of Gynaecology and Obstetrics of the Faculty of Medicine of Ribeirão Preto, São Paulo University, Ribeirão Preto, SP, Brazil. Electronic address: juliocrs@convex.com.br.
Julio Cesar
JC
Rosa-e-Silva
Sexual Medicine Service of Human Reproduction Sector, Department of Gynaecology and Obstetrics of the Faculty of Medicine of Ribeirão Preto, São Paulo University, Ribeirão Preto, SP, Brazil. Electronic address: mfsdesa@fmrp.usp.br.
Marcos Felipe
MF
Silva-de-Sá
Sexual Medicine Service of Human Reproduction Sector, Department of Gynaecology and Obstetrics of the Faculty of Medicine of Ribeirão Preto, São Paulo University, Ribeirão Preto, SP, Brazil. Electronic address: anasars@fmrp.usp.br.
Ana Carolina Japur de Sá
AC
Rosa-e-Silva
D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D047628:Estrogen Receptor alpha / Q000096:biosynthesis*; D005260:Female; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause / Q000378:metabolism*; D014596:Uterine Prolapse / Q000378:metabolism* / Q000473:pathology; D014621:Vagina / Q000098:blood supply* / Q000378:metabolism* / Q000473:pathology
C506487:ESR1 protein, human; D047628:Estrogen Receptor alpha
Estrogen; Menopause; Senescence; Sex hormones; Vagina