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Postmenopausal hormone therapy is accompanied by elevated risk for uterine prolapse
Päivi Rahkola-Soisalo1, Hanna Savolainen-Peltonen1,2, Mika Gissler3,4
1Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Menopause (New York, N.Y.)
|July 12, 2018
Summary
Postmenopausal hormone therapy, particularly estradiol with progestogens, may increase uterine prolapse risk. Longer exposure to hormone therapy correlates with higher prolapse risk, suggesting a need for updated patient information.
Area of Science:
- Gynecology
- Reproductive Health
- Pelvic Floor Disorders
Background:
- Estrogen and progesterone receptors are present in pelvic floor tissues.
- Postmenopausal hormone therapy (HT) may influence pelvic floor function.
- Uterine prolapse is a common condition affecting women's quality of life.
Purpose of the Study:
- To investigate the association between postmenopausal hormone therapy and uterine prolapse.
- To compare hormone therapy use in women who underwent uterine prolapse surgery versus controls.
Main Methods:
- Retrospective cohort study using Finnish national registers.
- Identified 12,072 women with uterine prolapse surgery and 33,704 controls.
- Analyzed hormone therapy use via drug reimbursement data and calculated odds ratios using conditional logistic regression.
Main Results:
- Women with uterine prolapse had higher rates of prior hormone therapy use (34.2% vs. 27.3%).
- Hormone therapy use was associated with a significant 23%-53% increased risk of uterine prolapse.
- Risk elevation was dose-dependent with longer exposure and comparable across different progestogen types, including levonorgestrel-releasing intrauterine devices.
Conclusions:
- Postmenopausal use of estradiol combined with progestogens may weaken the pelvic floor, leading to uterine prolapse.
- This finding necessitates updating patient information regarding the risks associated with estradiol-progestogen hormone therapy.
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