Association of endogenous circulating sex steroids and condition-specific quality of life domains in postmenopausal women with pelvic floor disorders

Arch Gynecol Obstet. 2018 Mar;297(3):725-730. doi: 10.1007/s00404-018-4650-7. Epub 2018 Jan 15.


Objective: To examine the relationship between endogenous sex steroids and various condition-specific quality of life domains in postmenopausal women with pelvic floor disorders. We hypothesized that woman with lowest androgen and estradiol concentrations would report worse scores of quality of life domains.

Methods: Forty-six women with pelvic organ prolapse (POP) and 47 cases with stress urinary incontinence (SUI) answered the validated pelvic floor questionnaire and underwent serum sex steroid measurement. A multivariate logistic regression model was used to determine the association between subjective outcome parameters and serum hormonal levels after adjusting for confounders.

Results: Univariate analysis revealed a strong inverse correlation between serum estradiol level (E2) and prolapse domain score (correlation coefficient = 0.005) as well as a significant positive correlation between SHBG level and prolapse domain score (correlation coefficient = 0.019) in cases with POP. Furthermore, the sex domain score showed a significant negative correlation with the androstendion (correlation coefficient = 0.020), DHEAS (correlation coefficient = 0.046) and testosterone level (correlation coefficient = 0.032) in the POP group. In the multivariate model, high serum SHBG (CI: 0.007-0.046) remained independently associated with worse scores in the prolapse domain and low serum DHEAS (CI: - 0.989 to 1.320) persisted as a significant predictor for a worse score in the sex domain. Regarding SUI cases, no association was noted between serum hormonal levels and quality of life related pelvic floor domains (correlation coefficient > 0.05).

Conclusion: Our results suggest that pelvic floor related quality of life might also be affected by endogenous sex steroids in POP, but not in SUI cases.

Keywords: Endogenous sex steroids; Health-related quality of life; Pelvic floor questionnaire; Pelvic organ prolapse; Postmenopausal women; Stress urinary incontinence.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Dehydroepiandrosterone Sulfate / blood
  • Estradiol / blood
  • Female
  • Follicle Stimulating Hormone / blood
  • Gonadal Steroid Hormones / blood*
  • Health Status
  • Humans
  • Middle Aged
  • Pelvic Floor Disorders / complications*
  • Pelvic Floor Disorders / psychology
  • Pelvic Organ Prolapse / blood*
  • Pelvic Organ Prolapse / complications
  • Postmenopause / blood*
  • Postmenopause / psychology
  • Quality of Life*
  • Retrospective Studies
  • Sex Hormone-Binding Globulin / metabolism
  • Surveys and Questionnaires
  • Urinary Incontinence, Stress / blood*
  • Urinary Incontinence, Stress / complications


  • Gonadal Steroid Hormones
  • Sex Hormone-Binding Globulin
  • Estradiol
  • Dehydroepiandrosterone Sulfate
  • Follicle Stimulating Hormone