Estrogen and Pelvic Organ Prolapse

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.