UROGENITAL ATROPHY IN CLIMACTERIC WOMEN: MENOPAUSE OR GERIPAUSE? Authors:

Deterioration of pelvic support and urinary and fecal control in women occurs after the menopause but it is not clear whether these manifestations are age or hormone related. Furthermore, it is not known whether estrogen deficiency after the menopause accelerates the adverse effects of biological ageing on female pelvic support and urinary and fecal continence mechanisms. This hypothesis can be tested in a female rat animal model with a long life span (Fischer 344) after ovariectomy and postoperative administration of estrogen and/or growth hormone releasing peptide (hexarelin) that has an anti-ageing effect, or no intervention. The results can be compared between aged and young adult rats using functional and morphological assessments at different hierarchical levels. These include the indicators of estrogen deprivation at the menopause such as amount and distribution of collagen fibres types I and III, number of vascular plexus in the urethral and anal canal submucosa, expression of estrogen receptors in the pelvic floor, urethra and anal canal and amount or relative distribution of muscle fibre types and the specific cellular markers of ageing such as expression of cytoplasmic p27kip1 protein in the pelvic floor and the urethral and anal sphincter muscles. This work may assist in understanding changes caused by biological versus reproductive senescence of the pelvic floor with a potential for improved and preventive therapeutic interventions in the climacteric population.