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Fracture risk linked to pelvic organ prolapse: collagen deficiencies may explain the presence of prolapse, bone fragility in postmenopausal women.(Gynecology)

OB GYN News

| May 01, 2006 | Johnson, Kate | COPYRIGHT 2006 International Medical News Group. This material is published under license from the publisher through the Gale Group, Farmington Hills, Michigan.  All inquiries regarding rights should be directed to the Gale Group. (Hide copyright information)Copyright

TORONTO -- Women with pelvic organ prolapse may be at more risk for fracture, according to a new analysis of data from the Women's Health Initiative trial.

"As a clinician, if I see a woman who is early postmenopausal with moderate to severe prolapse, it would behoove me to get her bone density assessed to quantify her risk for fracture, because now I believe this woman is more likely to have some form of fragility phenomenon happening," said principal investigator Dr. Lubna Pal of Albert Einstein College of Medicine, New York.

The study, which she presented as a poster at the annual meeting of the Society for Gynecologic Investigation, was based on the hypothesis that collagen deficiencies may be a unifying explanation for both pelvic organ prolapse (POP) and enhanced fracture risk in postmenopausal women, said Dr. Pal in an interview.

There is a high incidence of both prolapse and fractures in collagen-deficiency disorders such as Marfan syndrome and Ehlers-Danlos syndrome, she said. And the connection is biologically plausible, given that 90% of bone is collagen (thus making deficiency a risk factor for fracture) and that qualitative or quantitative deficiencies of tissue collagen may be more common in women with POP, than in women without.

The cross-sectional analysis included 11,096 postmenopausal women aged 60 years or more who were part of the entire WHI cohort. It found moderate to severe POP in 9% of the subjects and fragility ...

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