Pelvic organ prolapse: does hormone therapy use matter?

Area of Science:

• Urogynecology
• Reproductive Endocrinology
• Pelvic Floor Disorders

Background:

• Pelvic organ support is crucial for female pelvic health.
• Hormone therapy (HT) is used by many postmenopausal women.
• The impact of HT on pelvic organ support requires further investigation.

Purpose of the Study:

• To investigate the association between hormone therapy (HT) use and pelvic organ support.
• To evaluate the effect of systemic HT on pelvic organ support in postmenopausal women.

Main Methods:

• Retrospective observational study of 1443 postmenopausal women with pelvic floor dysfunction.
• Clinical examination including Pelvic Organ Prolapse Quantification (POP-Q) and 4D translabial ultrasound.
• Assessment of current/former systemic HT use and current local estrogen use.

Main Results:

• Current HT use was significantly associated with increased rectal ampulla descent and reduced Gh+Pb on ultrasound.
• Multivariate analysis confirmed the association between current HT and poorer pelvic organ support.
• Past HT use, duration of HT, or vaginal estrogen use showed no significant association.

Conclusions:

• Current hormone therapy (HT) may have a minor negative impact on pelvic organ support.
• The observed effect of HT on pelvic organ support is likely below the threshold for clinical relevance.
• Further research may clarify the long-term implications of HT on pelvic floor integrity.