title: Pelvic organ prolapse and endogenous circulating sex steroids in postmenopausal women: A case control-study.
abstract: OBJECTIVE
  We compared sex steroid levels of postmenopausal patients with symptomatic pelvic organ prolapse (POP) with postmenopausal matched patients without any sign of POP. Furthermore, we evaluated a possible relationship between sex steroid levels and various urogynecologic parameters in cases with POP. Main outcome of interest were differences in circulating estradiol levels between the two groups.
  
  
  METHODS
  We conducted a case-control study and 46 postmenopausal women with symptomatic POP≥stage 2 were matched 1:1 with 46 urogynecologic healthy women. Blood samples were drawn from all patients for assessment for estradiol (E2), Follicle-stimulating hormone (FSH), Luteinizing hormone (LH), testosterone (T), androstendion (AEON), dehydroepiandrosterone sulphate (DHEAS) and sex hormone binding globulin (SHBG) with an Electrochemiluminescence immunoassay.
  
  
  RESULTS
  Our study failed to show any statistically significant differences in sex steroid levels between women with and without POP (p>0.05). However, serum concentration of E2 (p<0,0001), free testosterone (p=0,034) and DHEAS (p=0,024) was statistically significant lower in patients with severe prolapse stage. Serum levels of E2 were statistically significant higher in cases with moderate-strong Oxford Grading Scale (p<0,0001). Low circulating E2 (p=0,019) as well as menopausal age (p=0,022) remained independent risk factors for POP in multiple logistic regression analysis.
  
  
  CONCLUSIONS
  The significant low hormonal levels in cases with high POP-Q stage as well as the significant higher estradiol levels in patients with strong Oxford Grading Scale may indicate that endogenous circulating sex steroids might have a potential role in the severity and progression of POP.
authors.affiliation: Department of General Gynecology and Gynecologic Oncology, Medical University of Vienna, Austria. Electronic address: Barbara.Bodner-Adler@meduniwien.ac.at.
authors.forename: Barbara
authors.initials: B
authors.lastname: Bodner-Adler
authors.affiliation: Department of General Gynecology and Gynecologic Oncology, Medical University of Vienna, Austria.
authors.forename: Klaus
authors.initials: K
authors.lastname: Bodner
authors.affiliation: Department of General Gynecology and Gynecologic Oncology, Medical University of Vienna, Austria.
authors.forename: Cora
authors.initials: C
authors.lastname: Schneidinger
authors.affiliation: Department of Anesthesiology, Medical University of Vienna, Austria; Outcomes Research Consortium, Cleveland, OH, USA.
authors.forename: Oliver
authors.initials: O
authors.lastname: Kimberger
authors.affiliation: Department of General Gynecology and Gynecologic Oncology, Medical University of Vienna, Austria.
authors.forename: Ksenia
authors.initials: K
authors.lastname: Halpern
authors.affiliation: Department of General Gynecology and Gynecologic Oncology, Medical University of Vienna, Austria.
authors.forename: Heinz
authors.initials: H
authors.lastname: Koelbl
authors.affiliation: Department of General Gynecology and Gynecologic Oncology, Medical University of Vienna, Austria.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Umek
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D005260:Female; D012739:Gonadal Steroid Hormones / Q000097:blood*; D006801:Humans; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000097:blood*; D017698:Postmenopause / Q000097:blood*
chemical_list: D012739:Gonadal Steroid Hormones
keywords: Association with urogynecologic parameters; Endogenous sex steroid levels; Pelvic organ prolapse