Pelvic floor dysfunction in women includes urinary incontinence and pelvic organ prolapse. In midlife, genitourinary atrophy is commonly associated with these conditions and can practically be considered part of the overall condition. The pelvic floor tissues share a common hormone responsiveness and as such respond collectively to midlife estrogen loss. This review article summarizes the expected consequences of menopause and aging on pelvic floor function and discusses how estrogen deprivation might lead to structural and/or functional failure. A framework for the initial evaluation of pelvic function in midlife women is presented, highlighting the importance of assessing the impact of incontinence, prolapse, and genitourinary atrophy on quality of life.
Keywords: Urinary incontinence; aging; estrogen; menopause; pelvic organ prolapse.