Pelvic organ prolapse and endogenous circulating sex steroids in postmenopausal women: A case control-study

Eur J Obstet Gynecol Reprod Biol. 2017 Mar;210:177-181. doi: 10.1016/j.ejogrb.2016.12.027. Epub 2016 Dec 26.


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.

Study design: 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.

Conclusion: 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.

Keywords: Association with urogynecologic parameters; Endogenous sex steroid levels; Pelvic organ prolapse.

MeSH terms

  • Aged
  • Case-Control Studies
  • Female
  • Gonadal Steroid Hormones / blood*
  • Humans
  • Middle Aged
  • Pelvic Organ Prolapse / blood*
  • Postmenopause / blood*


  • Gonadal Steroid Hormones