Abstract
The decline in sex hormone levels that accompanies the menopause has substantial effects on the tissues of the urogenital system, leading to atrophic changes. These changes can have negative effects on sexual and urinary function. The authors evaluate the repercussion of hypoestrogenism and sexual steroids on some elements of the pelvic floor and lower urinary tract. They summarize their research work and review significant published papers. They emphasize the changes in urinary mucosae, periurethral vessels, muscular layer, connective tissue, gene expression, autonomic nervous system receptors, as well as the main clinical aspects involved.
MeSH terms
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Aging / physiology
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Animals
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Atrophy
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Collagen / analysis
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Collagen / drug effects
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Cyclooxygenase 1 / genetics
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Estrogen Replacement Therapy
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Estrogens / deficiency*
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Estrogens / physiology
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Estrogens / therapeutic use
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Extracellular Matrix / metabolism
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Female
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Gene Expression
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Glycosaminoglycans / metabolism
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Humans
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Hyaluronic Acid / metabolism
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Microcirculation / drug effects
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Muscle, Smooth / drug effects
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Neovascularization, Physiologic / drug effects
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Pelvic Floor / blood supply
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RNA, Messenger / metabolism
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Receptors, Muscarinic / drug effects
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Receptors, Muscarinic / physiology
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Selective Estrogen Receptor Modulators / therapeutic use
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Urinary Incontinence / drug therapy
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Urinary Incontinence / physiopathology
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Urinary Tract / blood supply
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Urinary Tract / metabolism*
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Urothelium / drug effects
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Urothelium / physiology*
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Uterine Prolapse / physiopathology
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Vagina / metabolism
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Vagina / pathology
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Vascular Endothelial Growth Factor A / drug effects
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Vascular Endothelial Growth Factor A / genetics
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Vascular Endothelial Growth Factor A / metabolism
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beta 2-Microglobulin / genetics
Substances
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Estrogens
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Glycosaminoglycans
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RNA, Messenger
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Receptors, Muscarinic
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Selective Estrogen Receptor Modulators
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Vascular Endothelial Growth Factor A
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beta 2-Microglobulin
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Hyaluronic Acid
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Collagen
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Cyclooxygenase 1