Spirometric disorders in women with genital descensus

Relationship between symptomatic pelvic organ prolapse and respiratory muscle strength in middle-aged and older women in Northeast Brazil: a cross-sectional study

Some respiratory muscles work in synergy with the pelvic floor (PF). Pelvic organ prolapse (POP) is characterized by weak PF muscles and has been associated with worse pulmonary ventilation function in women. To date no studies have investigated the association between respiratory muscle strength and POP. This study aimed to determine whether symptomatic POP is associated with respiratory muscle strength in middle-aged and older women. In this observational cross-sectional study, 204 community-dwelling women (41-80 years old) from Santa Cruz (Northeastern Brazil) provided information on socioeconomic characteristics, health behavior, reproductive history and symptomatic POP via a structured questionnaire. A digital manometer was used to measure their maximal inspiratory and expiratory pressures (MIP and MEP). Multiple linear regression analyses, adjusted for covariates (age, income, education, body mass index, and smoking), evaluated the association between POP and MIP/MEP. The results show that 14.7% of the sample reported symptomatic POP. These women exhibited lower mean MIP and MEP than those reporting no POP, but the intergroup difference was only significant for MEP (p = .01). The association between POP and MEP remained statistically significant, even after covariates (β = 11.9, p = .04) were adjusted. Symptomatic POP is associated with expiratory muscle strength in middle-aged and older women. This innovative research provides important information regarding the need to evaluate the integrity of PF muscles when assessing respiratory muscle strength, which may help clinicians devise preventive and treatment strategies to improve women's health during the aging process.

Estrogen replacement therapy improves pulmonary function in postmenopausal women with genital prolapse

OBJECTIVE

This study examined the impact of estrogen replacement therapy with spirometry on pulmonary function in surgically castrated (salpingo-oophorectomy) postmenopausal women with genital prolapse.

METHODS

The study included 60 postmenopausal women with pelvic organ prolapse. The study received institutional Ethics Committee approval, and all subjects signed an informed consent. Women were randomly divided into two groups of 30 subjects: Group 1 (n=30) was administered estrogen replacement with 1 mg of stradiol hemihydrate (1 mg/day) orally for 6 months, and group 2 (n=30) was not taking estrogen. Both groups were matched by age, height, body mass index, parity, and duration of postmenopause. All subjects were evaluated with spirometry initially and after 6 months. For statistical analysis, descriptive and analytical methods were used, based on data type and distribution. The mean and standard deviations were used as measures of central tendency and variability. Categorical data were expressed as absolute and relative numbers (percentage). The t-test for independent samples (for comparison of groups) and t-test for dependent samples (for comparison of serial measurements in the same patients) were used. The analysis was performed using R software ( www.r-project.org ), with the level of significance set at p<0.05.

RESULTS

Analysis of spirometry parameters showed statistically significant differences between the estrogen users and the nonusers groups.

CONCLUSION

The most important study result was the significantly improved lung respiratory function in postmenopausal women with genital prolapse after 6 months of taking estrogen, confirming that hormone replacement therapy should be recommended to postmenopausal women. The findings of our study suggest the need for further research into the effect of estrogen on pulmonary function.

Oral contraceptives improve lung mechanics

OBJECTIVE

To determine whether oral contraceptives affect lung mechanics.

DESIGN

Open-label study.

SETTING

Academic medical center.

PATIENT(S)

Thirty-six healthy nonsmoking women.

INTERVENTION(S)

Administration of an oral contraceptive containing ethinyl estradiol, 35 microg, and norgestimat, 250 microg for 6 months.

MAIN OUTCOME MEASURE(S)

Forced vital capacity; forced expiratory volume in 1 second; peak expiratory flow; and flow at large, medium, and small lung volumes.

RESULT(S)

At 6 months, all forced expiratory flow and volume had increased significantly (from 6.5% to 15%). Flows at small lung volumes especially increased.

CONCLUSION(S)

Combination oral contraceptives have a measurable effect on lung mechanics.