OBJECTIVES: A significant body of knowledge implicates menopausal estrogen levels in the pathogenesis of the common pelvic floor disorders (PFDs). These health conditions substantially decrease quality of life, increase depression, social isolation, caregiver burden, and economic costs to the individuals and society. METHODS: This review summarizes the epidemiology of the individual PFDs with particular attention to the understanding of the relationship between each PFD and menopausal estrogen levels, and the gaps in science and clinical care that affect menopausal women. In addition, we review the epidemiology of recurrent urinary tract infection (rUTI)-a condition experienced frequently and disproportionately by menopausal women and hypothesized to be potentiated by menopausal estrogen levels. RESULTS: The abundance of estrogen receptors in the urogenital tract explains why the natural reduction of endogenous estrogen, the hallmark of menopause, can cause or potentiate PFDs and rUTIs. A substantial body of epidemiological literature suggests an association between menopause, and PFDs and rUTIs; however, the ability to separate this association from age and other comorbid conditions makes it difficult to draw definitive conclusions on the role of menopause alone in the development and/or progression of PFDs. Similarly, the causative link between the decline in endogenous estrogen levels and the pathogenesis of PFDs and rUTIs has not been well-established. CONCLUSIONS: Innovative human studies, focused on the independent effects of menopausal estrogen levels, uncoupled from tissue and cellular senescence, are needed.
OBJECTIVES: A significant body of knowledge implicates menopausal estrogen levels in the pathogenesis of the common pelvic floor disorders (PFDs). These health conditions substantially decrease quality of life, increase depression, social isolation, caregiver burden, and economic costs to the individuals and society. METHODS: This review summarizes the epidemiology of the individual PFDs with particular attention to the understanding of the relationship between each PFD and menopausal estrogen levels, and the gaps in science and clinical care that affect menopausal women. In addition, we review the epidemiology of recurrent urinary tract infection (rUTI)-a condition experienced frequently and disproportionately by menopausal women and hypothesized to be potentiated by menopausal estrogen levels. RESULTS: The abundance of estrogen receptors in the urogenital tract explains why the natural reduction of endogenous estrogen, the hallmark of menopause, can cause or potentiate PFDs and rUTIs. A substantial body of epidemiological literature suggests an association between menopause, and PFDs and rUTIs; however, the ability to separate this association from age and other comorbid conditions makes it difficult to draw definitive conclusions on the role of menopause alone in the development and/or progression of PFDs. Similarly, the causative link between the decline in endogenous estrogen levels and the pathogenesis of PFDs and rUTIs has not been well-established. CONCLUSIONS: Innovative human studies, focused on the independent effects of menopausal estrogen levels, uncoupled from tissue and cellular senescence, are needed.
Authors: Marianna Alperin; Steven Abramowitch; May Alarab; Maria Bortolini; Bryan Brown; Lindsey A Burnett; Kathleen A Connell; Margot Damaser; Raffaella de Vita; Caroline E Gargett; Marsha K Guess; Zeliha Guler; Renato Natal Jorge; Robert S Kelley; Mark Kibschull; Kristin Miller; Pamela A Moalli; Indira U Mysorekar; Megan R Routzong; Oksana Shynlova; Carolyn W Swenson; Marrisa A Therriault; Gina M Northington Journal: Int Urogynecol J Date: 2022-06-08 Impact factor: 1.932
Authors: Marianna Alperin; Steven Abramowitch; May Alarab; Maria Bortolini; Bryan Brown; Lindsey A Burnett; Kathleen A Connell; Margot S Damaser; Raffaella de Vita; Caroline E Gargett; Marsha K Guess; Zeliha Guler; Renato Natal Jorge; Robert S Kelley; Mark Kibschull; Kristin Miller; Pamela A Moalli; Indira U Mysorekar; Megan R Routzong; Oksana Shynlova; Carolyn W Swenson; Marrisa A Therriault; Gina M Northington Journal: Female Pelvic Med Reconstr Surg Date: 2022-05-24 Impact factor: 1.913
Authors: Megan S Bradley; Michael Stanger; Cassie Ford; Jerry Lowder; Victoria L Handa Journal: Female Pelvic Med Reconstr Surg Date: 2022-04-01 Impact factor: 1.913
Authors: M-L Marschalek; K Bodner; O Kimberger; S Zehetmayer; R Morgenbesser; W Dietrich; C Obruca; H Husslein; W Umek; H Koelbl; B Bodner-Adler Journal: BJOG Date: 2021-09-21 Impact factor: 7.331
Authors: Holly N Wilkinson; Benjamin Reubinoff; David Shveiky; Matthew J Hardman; Ofra Ben Menachem-Zidon Journal: Front Endocrinol (Lausanne) Date: 2022-08-11 Impact factor: 6.055