Anorectal manometry before, during and after estrogen replacement therapy

Abstract

The incidence of relaxation of the pelvic floor increases with age, and although a relation between prolapse and the decline of estrogens has been suggested, there is no objective evidence. Together with urodynamic measurements, anal manometry is one of the few ways of making an objective assessment of the strength of pelvic structures located in and near the pelvic floor. In order to study the role of estrogens, anal manometry was performed before, during and after estrogen replacement therapy with daily oral use of 0.625 mg conjugated estrogens for 6 months. Five postmenopausal women, who had not used estrogen replacement therapy in the past, were included in the study. None of the manometric parameters, including maximal anal resting pressure, maximal squeeze pressure and internal anal sphincter response, changed. It was concluded that estrogens have no effects on manometric parameters of the external sphincter and that anal manometry may not be the appropriate method to assess the effects of estrogens on the pelvic floor.

Estrogènes et fonction ano-rectale

“…Deux premières études pilotes reposant sur de petits effectifs n'ont pas montré de bénéfice symptomatique ou physiologique à court terme (trois à six mois) d'un traitement estrogé-nique substitutif chez des femmes ménopausées [21,22]. [20], la fréquence des selles n'était pas significativement modifiée par le traitement hormonal substitutif.…”