São Paulo University-Sexual Medicine Service of Human Reproduction Sector, Department of Gynaecology and Obstetrics, Av. Bandeirantes, 3.900 Ribeirão Preto São Paulo 14040-901, Brazil.
J Sex Med. 2009 Nov;6(11):3097-110. doi: 10.1111/j.1743-6109.2009.01407.x. Epub 2009 Jul 28.
Hypoestrogenism causes structural changes in the vaginal wall that can lead to sexual dysfunction. A reduction in vaginal wall thickness has been reported to occur after menopause, although without precise morphometry.
To measure vaginal wall thickness in women with genital prolapse in normal and hypoestrogenic conditions and to correlate sexual dysfunction with vaginal wall thickness and estradiol levels.
Surgical vaginal specimens from 18 normoestrogenic and 13 postmenopausal women submitted to surgery for genital prolapse grades I and II were examined. Patients were evaluated for FSH, estradiol, prolactin, glycemia, and serum TSH levels. For histological analysis, samples were stained with Masson's trichrome and hematoxylin-eosin. Sexual function was assessed by the Golombok-Rust Inventory of Sexual Satisfaction (GRISS).
GRISS questionnaire, histological analysis, morphometric methods, Masson's trichrome.
The vaginal wall was thicker in the postmenopausal than premenopausal group (2.72 +/- 0.72 mm and 2.16 +/- 0.43, P = 0.01, and 2.63 +/- 0.71 mm and 2.07 +/- 0.49 mm, P = 0.01, for the anterior and posterior walls, respectively). These thicknesses seem to be due to the muscular layer, which was also thicker in the postmenopausal group (1.54 +/- 0.44 and 1.09 +/- 0.3 mm, P = 0.02, and 1.45 +/- 0.47 and 1.07 +/- 0.44 mm, P = 0.03, for the anterior and posterior wall, respectively). The vaginal epithelium was thinner in the middle segment than in the proximal one in the posterior wall (0.17 +/- 0.07 mm, 0.15 +/- 0.05 mm, 0.24 +/- 0.09 mm, P = 0.02). There was no correlation between coital pain, vaginal wall thickness, and estradiol levels in either group.
The vaginal wall is thicker after menopause in women with genital prolapse. In this study, vaginal thickness and estrogen levels were not related to sexual dysfunction.
低雌激素会导致阴道壁结构发生变化，从而导致性功能障碍。尽管没有精确的形态测量学，但据报道，绝经后阴道壁厚度会减少。
测量患有生殖器脱垂的女性在正常和低雌激素状态下的阴道壁厚度，并将性功能障碍与阴道壁厚度和雌二醇水平相关联。
对 18 名正常雌激素和 13 名绝经后妇女的阴道手术标本进行了检查，这些妇女因生殖器脱垂 I 级和 II 级而接受了手术。对患者进行了 FSH、雌二醇、催乳素、血糖和血清 TSH 水平的评估。为了进行组织学分析，样品用 Masson 三色和苏木精-伊红染色。通过 Golombok-Rust 性满意度问卷（GRISS）评估性功能。
GRISS 问卷、组织学分析、形态计量学方法、Masson 三色。
绝经后组的阴道壁比绝经前组厚（前壁分别为 2.72±0.72mm 和 2.16±0.43mm，P=0.01；后壁分别为 2.63±0.71mm 和 2.07±0.49mm，P=0.01）。这些厚度似乎是由于肌肉层较厚所致，绝经后组的肌肉层也较厚（前壁分别为 1.54±0.44mm 和 1.09±0.3mm，P=0.02；后壁分别为 1.45±0.47mm 和 1.07±0.44mm，P=0.03）。阴道上皮在后壁中段比近端薄（0.17±0.07mm，0.15±0.05mm，0.24±0.09mm，P=0.02）。在两组中，性交疼痛、阴道壁厚度和雌二醇水平之间均无相关性。
患有生殖器脱垂的女性绝经后阴道壁较厚。在这项研究中，阴道厚度和雌激素水平与性功能障碍无关。
