Molecular and Genetic Medicine

Estrogen and Pelvic Organ Prolapse

Abstract

Ling Zhou, Anna Junjie Shangguan, Stacy Ann Kujawa, Katarzyna Bochenska, Lanmei Zhang, Serdar E. Bulun and Hong Zhao

Pelvic organ prolapse (POP) is a multifactorial disease with a complex and largely unknown etiology and pathophysiology. Hypoestrogenemia may be one of the risk factors associated with POP. Recent studies suggest a potential role of estrogen and its receptors in the pathogenesis of POP. Here, we summarize current research regarding the relationship between estrogen and POP to establish a theoretical foundation for using estrogen in POP treatment. Estrogen plays an important role in collagen and elastin metabolism of connective tissues through down-regulating matrix metalloproteinases and increasing cystatin C expression. However, previous studies have shown contradictory data regarding estrogen receptor expression in patients with POP compared to non-POP controls. At this time, there is no conclusive evidence suggesting a causal role of estrogen in POP. Further welldesigned studies are necessary to illuminate both the molecular mechanisms of estrogen function and the role of estrogen in POP.