Urogenital Biomolecular and Physical Measures in Pre- and Post-Menopausal Women

Background: A clinical study was conducted to evaluate biomolecules and physical measures in the urogenital skin of pre-menopausal and post-menopausal women. Methods: A total of 45 female subjects (aged 21 - 70 years) were enrolled in the study and assigned to one of three groups: 15 pre-menopausal (pre-M), 15 post-menopausal receiving no form of hormone replacement therapy (post-M non-HRT), and 15 post-menopausal receiving HRT (post-M HRT). Self-assessed symptoms were recorded from each group (i.e. dryness, itch and difficulty with intercourse). Skin temperature and pH, and quantification of biomolecules (via tape strip samples) were obtained from the labia majora, labia minora and introitus. Vaginal pH was also collected. Results: More post-menopausal subjects (HRT and non-HRT) reported genital symptoms of external and vaginal dryness, and difficulties with intercourse. External genital skin itch was reported more frequently in the post-M non-HRT group. Skin temperature was lower in both post-M groups indicating reduced blood perfusion. The pH was significantly higher for the post-M non-HRT group at the vagina, introitus and labia minora compared to the pre-M group. Histamine was significantly reduced in both post-M groups; however, histamine levels did not correlate with complaints of itching. The concentration of natural moisturizing factors (NMFs) did not differ consistently between groups. Concentrations of IL-1α tended to be lower in the pre-M group at all three body sites. Conclusions: This is the first report of non-invasive measures of temperature, pH, biomolecules of vulvar tissue in post- and pre-menopausal women. Based on results of histamine analyses, we propose that reduced histamine levels in post-menopausal women are related to sexual and lubrication difficulties, and reduced blood perfusion. J Clin Gynecol Obstet. 2015;4(3):237-250 doi: http://dx.doi.org/10.14740/jcgo347e