Non-evidence of estrogen receptors in the rectal mucosa

The aim of the study was to investigate whether estrogen receptors are present in the rectal mucosa of premenopausal women compared to post-menopausal women and men. Thirty biopsies obtained from the rectal mucosa at colonoscopy, performed to investigate inflammatory bowel disease in 23 patients and neoplasia in 7, were examined by the avidin-biotin-peroxidase immunohistochemical technique for the presence of estrogen receptors. The study group (n=10) were non-pregnant premenopausal women and the control group (n=20) were postmenopausal women (n=10) and men (n=10). None of the subjects had fecal incontinence or was taking medication with hormones. In no case did the primary lesion involve the specimen used for laboratory analysis. All samples showed negative immunostaining for estrogen receptors. It was concluded that in continent women and men, a direct estrogenic effect on the rectal mucosa seems unlikely.Editorial Comment: This investigation attempts to determine the presence or absence of estrogen receptors in the rectal mucosa, linking the development of fecal incontinence to hypoestrogenism much like the effect of estrogen on the lower urinary tract. Unlike a previous study [1], which found estrogen receptors in the external anal sphincter in women, no such receptors are found in the rectal mucosa in the present study, regardless of patient gender or menopausal status. However, as the samples taken were superficial mucosal biopsies performed at the time of colonoscopy for evaluation of colonic inflammation of neoplasia, it is possible that estrogen receptors are located at deeper tissue levels and were missed by the sampling technique. It is also possible that the patients' underlying bowel condition influenced the distribution of estrogen receptors within the tissue. Future investigation should obtain samples from the entire thickness of the bowel wall, such as biopsies obtained during proctocolectomy. Further information is needed as to the distribution of estrogen receptors in the bowel wall and the possible correlation to fecal incontinence in women.     

Changes in the Lower Urinary Tract in Continent Women and in Women with Stress Urinary Incontinence, According to Menopausal Status

The aim of this study was to assess the impact of the postmenopausal period on clinical and urodynamic parameters and on the mobility of the bladder neck in continent women and in women with stress urinary incontinence. Fifty-seven postmenopausal women were studied: 30 were continent and 27 had stress urinary incontinence. They were subdivided according to postmenopausal stage into groups A (<5 years) and B (>5 years). Five years was a good marker to separate those women with mild and severe estrogen deficiency. Fifteen premenopausal incontinent women were selected for bladder neck ultrasound as controls. All underwent history, general physical and gynecologic examinations, LH and FSH determinations, type 1 urine and uroculture, circadian voiding diary, cotton-swab test, bladder neck ultrasound and urodynamic investigations. Analysis of the voiding diaries revealed a higher frequency of daytime micturition in both groups of incontinent patients than in the continent ones. Increased bladder neck mobility was also found, both in the cotton-swab test and an ultrasound, in group A and an ultrasound in the premenopausal incontinent women. Urodynamic investigation showed decreased bladder capacity at the first micturition urge, as well as decreased urinary volume in the group A patients compared to the continent ones. Decreased urethral closure maximum pressure was also found in group B patients in relation to the continent ones. We concluded that the effect of hypoestrogenism, manifested postmenopause, causes changes in the lower urinary tract of women, particularly those who are incontinent.     

Oestrogen and progesterone receptor expression in the female lower urinary tract, with reference to oestrogen status

OBJECTIVE: To assess the incidence and distribution of both oestrogen and progesterone receptors throughout the female lower urinary tract, and to compare receptor expression in women of varying oestrogen status. PATIENTS AND METHODS: The study included 90 women undergoing surgery for urogynaecological conditions; 33 were premenopausal, 26 postmenopausal and taking no oestrogen supplementation, and 31 postmenopausal and receiving some form of hormone-replacement therapy. Biopsies were taken during surgery from the bladder dome, trigone, proximal urethra, distal urethra, vagina and vesicovaginal fascia in the region of the bladder neck. All biopsies were routinely fixed and processed for histopathological assessment, and were then labelled immunohistochemically with monoclonal antibodies directed against human oestrogen (NCL-ERLH2) and progesterone (NCL-PGR) receptors. Both oestrogen and progesterone receptor expression were assessed in the epithelial, subepithelial and muscle/deeper fascial regions of all tissue for overall tissue positivity for each receptor, and by semiquantitative analysis of receptor concentration using histochemical scoring of the tissues. RESULTS: Oestrogen receptors were consistently detected in the squamous epithelia and were consistently absent in the urothelial tissues of the lower urinary tract of all women irrespective of oestrogen status; there was no significant variation in histological score. Progesterone receptor expression was more variable, being mostly subepithelial, and significantly lower in postmenopausal women receiving no oestrogen replacement. CONCLUSION: These findings confirm the female lower urinary tract to be a target organ for the action of oestrogen and progesterone, and shed further light on the areas of the lower urinary tract likely to respond to hormone-replacement therapy. This may have implications for the use of oestrogen supplementation in the treatment of lower urinary tract disorders of postmenopausal women.     

Location and concentration of estrogen,progesterone, and androgen receptors in the bladder and urethra of the rabbit

The objective of this study was to determine location and concentration of estrogen, androgen and progesterone receptors in the bladder and urethra of the rabbit. Two urethral and two bladder specimens were obtained from four 12-week-old female New Zealand white rabbits. Rat monoclonal antibody (AN 1–15) to human androgcn receptor and (H222) to human estrogen receptor and mouse monoclonal antibody (PR6) to chicken progesterone receptor were used. Immunocytochemical staining was performed and specimens were evaluated lor presence and location of steroid receptors. Androgen receptors were found in the highest concentrations in urethral and bladder epithelium. Low to low/moderate concentration were found in smooth muscle. Estrogen receptors were found in moderate to moderate/high concentrations in urethral epithelium and bladder and urethral smooth muscle. Progesterone receptors were not found in appreciable concentrations from any location, though the animals were not pretreated with estrogen. The rabbit model suggests a mechanism by which estrogen therapy can be effective in treating postmenopausal lower urinary tract symptoms. Progesterone receptors were not found in appreciable concentrations, suggesting progesterone therapy may not diminish the effectiveness of estrogen therapy by acting on urethral progesterone receptors. The effect of androgcns on the lower urinary tract needs further investigation to determine if androgen therapy can alleviate lower urinary tract symptoms. © 1995 Wiley-Liss, Inc.     

Impact of menopausal status on the behavior of pancreatic cystic neoplasms in women

PURPOSE: Pancreatic cystic neoplasms have predilections for occurring in young women, for containing "ovarian-like" stroma, and for expressing estrogen and progesterone receptors; these factors suggest a potentially important influence of the hormonal milieu on the biology of these tumors. Therefore, we examined the impact of menopausal status on the clinical features of pancreatic cystic neoplasms in women. METHODS: Seventy-six women with pancreatic cystic neoplasms treated at our institution from 1992 to 2003 were classified into 2 groups according to menopausal status based on the U.S. average menopausal age of 51 years: group I (premenopausal, ages 22-50; n = 36) and group II (postmenopausal, ages 51-80; n = 40). Chi-square and the 2-tailed t-tests compared categorical and continuous variables, respectively. Kaplan-Meier survival estimates were determined and compared with the log rank test. RESULTS: Abdominal pain at presentation occurred more commonly among group I than among group II patients (78% vs 48%, p < 0.05). Solid pseudopapillary tumors were more prevalent among group I than among group II patients (21% vs 3%, p = 0.02). CONCLUSIONS: The clinicopathologic features of pancreatic cystic neoplasms in premenopausal women are not significantly different from those in postmenopausal women. Menopausal status should not bias diagnostic and treatment algorithms for women with these neoplasms.     

Steroid hormone receptors in laryngeal carcinoma

The larynx has long been shown to be a target organ for androgenic steroids in both women and men, and specific androgen receptors have been determined in normal laryngeal mucosa and in laryngeal carcinoma tissue. In this study, samples from 21 primary laryngeal carcinomas, from 4 recurrent laryngeal carcinomas and from 1 cervical metastasis of laryngeal carcinoma were obtained at the time of surgery to assay specific androgen, estrogen, and progesterone receptors. Specific androgen receptors were found in 8 samples (31%). The level of receptors varied from 1.7 femtomoles (fmol) per milligram to 7.3 fmol/mg cytosol protein. Detectable levels of specific estrogen receptors were found in 18 samples (69%) and progesterone receptors in 8 of the 15 samples studied (53%). There was no apparent correspondence with donors' sex, since samples from both females and males contained all kinds of receptors. We know that antiestrogen inhibits the growth of squamous carcinoma cells lines positive for estrogen receptors in vitro and that this effect is reversible with the appropriate hormone. Thus, the relatively high percentage of estrogen and progesterone receptors found in laryngeal carcinoma tissue may open new aspects in the treatment of laryngeal carcinoma with antihormones.     

Effects of ovariectomy and hormone replacement on collagen and blood vessels of the urethral submucosa of rats

Collagen and blood vessels of the urethral submucosa of ovariectomized rats were studied following 28 daily subcutaneous injections of 17-beta estradiol (n=6, group 1), medroxy-progesterone acetate (n=6, group 2), both drugs (n=6, group 3) or vehicle (n= 6, control) and after sham surgery without castration or injection (n=6). Investigations included the immunohistochemistry of estrogen and progesterone receptors and collagen fibres, Western blot analysis of collagen types I and III and counting periurethral vessels by light microscopy. Our results showed positive immunostaining with estrogen, progesterone and collagen types I and III in all samples. Collagen type I and III levels were lower in the controls than in the sham group. The other groups showed increases (2>3>1) over the controls with a relatively higher increase in type III. The type I/III collagen ratio progressively decreased (control>1>2>3) below sham levels. The mean vessel count was significantly lower in control than in sham animals (P<0.00001). However, only estrogen treatment significantly increased the vessel number compared to controls (P=0.04). Our results indicate that estrogen and progesterone, alone or in combination, have an effect on collagen types I and III, and that estrogen has an effect on blood vessels of the urethral submucosa in female rats.     

Progesterone receptors in the female lower urinary tract

When female estrogenized rabbits were injected i.v. with 3H-progesterone, the tritium concentration determined after one hour was about two to three times higher in urethra, urinary bladder and vagina than in the heart. High affinity progesterone receptors (KD = 1-2 nM) could be demonstrated in both cytoplasmic and nuclear fractions prepared from estrogenized rabbit urethra, bladder and vagina. The cytosolic receptor concentration in both urethra and bladder was about half of that in the vagina. The concentration of nuclear receptors in urethra was not significantly different from that in the vagina, but in the bladder the concentration was only about one fourth of that in the vagina or urethra. The mean KD of cytosolic receptors from bladder was significantly higher than the corresponding values in urethra and vagina. Progesterone binding sites in the bladder had a broader hormonal specificity than those in the urethra or vagina. The present demonstration of specific progesterone receptors in the female urethra might provide a possible link between estrogen progesterone interaction and the appearance of urinary incontinence during pregnancy in women.     

倍美力对绝经后妇女纤溶活性的影响

为了探讨激素替代治疗（ＨＲＴ）的心血管保护机制，观察了倍美力对绝经后妇女纤溶活性的影响。４８例绝经后妇女分为３组：安慰剂组１０例；单用倍美力组（Ｅ组）１７例；倍美力、孕激素合用组（Ｅ＋Ｐ组）２１例，并以２０例绝经前妇女作为对照。采用发色底物法测定了ＨＲＴ治疗前及治疗３个月后血浆组织纤溶酶原激活剂（ｔＰＡ）及其抑制因子（ＰＡＩ）活性。结果：绝经后妇女治疗前ＰＡＩ活性明显高于对照组（Ｐ＜０．０１）。安慰剂组治疗前后ｔＰＡ及ＰＡＩ均无显著性变化（Ｐ＞０．０５）。Ｅ及Ｅ＋Ｐ组治疗３个月后ＰＡＩ活性明显减低，ｔＰＡ活性明显升高（Ｐ＜０．０１），两组比较，治疗前后ｔＰＡ及ＰＡＩ活性均无显著性差异。认为ＨＲＴ可通过改善绝经后妇女纤溶活性保护心血管。     

Overactive bladder in the female patient: the role of estrogens

The prevalence of urinary incontinence is known to increase with age, affecting 15% to 35% of communitydwelling women over 60 years of age. Other studies report a prevalence of 49% in women over 65 years of age. Epidemiologic studies have implicated estrogen deficiency in the etiology of lower urinary tract symptoms, although the role of estrogen replacement therapy remains controversial. This review presents recent evidence regarding the role of estrogen in lower urinary tract dysfunction, with a particular emphasis on the management of postmenopausal women with symptoms suggestive of overactive bladder.     

Distal urethral compensatory mechanisms in women with an incompetent bladder neck who remain continent,and the effect of the menopause

Female continence is thought to be maintained at the level of the bladder neck and by the external sphincter. However, many women have an incompetent bladder neck, that is their bladder neck opens under stress. However, they still remain continent, presumably by use of their distal external sphincter. To establish the effect of age and the menopause on this phenomenon, data from 202 climacteric urodynamically normal and continent women were examined. The overall prevalence of videocystourethographically diagnosed bladder neck incompetence in these women was 51 ± 4%. The median age in this group was 50.4 years but the prevalence of bladder neck incompetence in women below 50.4 years was not significantly different from older women (>50.4 years) being 49 ± 5% and 53 ± 5%, respectively. Of the 202 women studied the prevalence of bladder neck incompetence in perimenopausal women was 54 ± 5% and 48 ± 5% in postmenopausal women, there being no statistically significant difference between the two subgroups separated on the basis of their estrogen status. These data do not support the contention that bladder neck integrity is estrogen dependent nor is there any evidence from these data that is it age dependent. To understand how women with bladder neck incompetence maintain continence, 55 of the 202 women also underwent urethral pressure profilometry. Bladder neck incompetence results in a proximal shortening of the stress urethral pressure profile but these women maintained their stress urethral functional length by decreased distal shortening of the stress profile. In other words, they made more use of the distal portion of the urethra. This is achieved by augmentation of their distal transmission pressure ratios.     

Estrogen and progesterone binding by acoustic neuroma tissue

Tissue samples from 37 acoustic neuromas were assayed for estrogen and progesterone hormone receptor binding by radioimmunoassay using a dextran-coated charcoal method and Scatchard plot analysis. Twenty-one of the samples were from men, and 16 of the samples were from women. Seven of 37 samples (19%) were positive for estrogen receptor and six of 36 samples (17%) were positive for progesterone receptor. Three of 37 samples (8%) were positive for both receptors. There was no correlation of estrogen receptor positivity with the sex of the patient. These results indicate that estrogen or progesterone receptor binding activity or both are present in a small subset of acoustic tumors. Evidence is lacking, however, that binding of estrogen to the receptor results in growth changes in the tumor. The empirical use of antiestrogen treatment in acoustic neuroma does not appear to be justified at the present time.     

年龄和雌激素对绝经后妇女骨转换生化指标的影响

目的调查骨转换生化指标的差异,并评估激素和年龄相关因素与绝经前和绝经后妇女生化指标的关系。方法选取在2016年1月至2018年1月期间在我院就诊的女性患者作为研究对象。根据问卷调查,共选出496名健康女性,其中绝经前244例,绝经后女性252例。根据试剂制造商提供的指南评估不同的骨标志物,并且采用化学发光免疫测定法进行激素测定,特别是雌二醇水平评估。结果与绝经前妇女相比,绝经后妇女血清钙水平和雌二醇水平显著降低,而绝经后妇女血清磷和碱性磷酸酶(ALP)水平显著升高(P0.05)。年龄与绝经后骨标志物(ALP和钙)显著相关(P 0.05),而绝经前组无显著相关性。绝经后妇女钙与雌二醇之间呈显著正相关,而ALP与雌二醇之间呈显著负相关。此外,在体质指数和年龄校正偏相关分析中,绝经后妇女雌二醇和骨标志物之间没有显著相关性。结论绝经后女性雌激素水平和骨代谢异常对骨质疏松症的预测有积极的意义。     

The effect of ovariectomy and long-term estrogen replacement on bladder structure and function in the rat

PURPOSE The use of estrogen replacement therapy for treating postmenopausal urinary incontinence is a controversial topic. We examined the behavioral, cystometric and histological changes that occur with long-term estrogen depletion and supplementation in rat bladders to determine the role of menopause in lower urinary tract dysfunction.MATERIALS AND METHODS A total of 40 female Sprague-Dawley rats were placed into 1 of 3 groups, including bilateral ovariectomy, bilateral ovariectomy plus estrogen replacement and control. The estrogen replaced group received a 0.25 mg. 16-week sustained release pellet (Innovative Research of America, Sanasota, Florida) placed subcutaneously. After surgery voiding frequency and volume were measured in 24-hour periods by placing animals in metabolic cages. After 16 weeks the rats underwent catheterization and continuous cystometry. The bladder was then removed and stained with Gomori trichrome. The collagen-to-smooth muscle density ratio was calculated for each specimen using current imaging software.RESULTS There was no significant difference in voiding patterns in the 3 groups, as measured by volume and voiding frequency. Cystometric data showed a trend toward higher voiding pressure, threshold pressure, baseline pressure and mean inter-voiding pressure in the ovariectomy group compared with the estrogen and control groups, although there was no statistical significance. Histological studies showed a higher mean collagen-to-smooth muscle ratio plus or minus standard deviation in the ovariectomy group (0.807 +/- 0.204) than in the ovariectomy plus estrogen replacement (0.709 +/- 0.118) and control (0.700 +/- 0.129) groups (p <0.05). Furthermore, when histological and cystometric data were compared for individual samples, we found a direct correlation of mean inter-voiding pressure (a measure of bladder instability) with the collagen-to-smooth muscle ratio (p <0.05).CONCLUSIONS Long-term estrogen replacement is beneficial for treating postmenopausal urinary incontinence.     

Specific Changes of Urinary Excretion of Cross-Linked N-Telopeptides of Type I Collagen in Pre- and Postmenopausal Women: Correlation with Other Markers of Bone Turnover

Urinary excretion of cross-linked N-telopeptide of type I collagen (NTx) has been reported to be a specific marker of bone resorption [18]. We assessed a new immunoassay for NTx as an indicator of changes in bone resorption caused by spontaneous menopause and compared cross-sectionally the levels of urinary NTx, hydroxylysylpyridinoline (HP), lysylpyridinoline (LP), hydroxyproline (OH-Pr), other serum biochemical indices, and lumbar spine and proximal femur bone mineral density (BMD). Eighty-one Japanese women aged 22–77 participated in this study; 36 were premenopausal and 45 were postmenopausal. Urinary HP, LP, and NTx stayed at low levels in the premenopausal period and rose 21%, 30%, and 67% in the postmenopausal period, respectively. The rise in LP and NTx was statistically significant (P < 0.01), suggesting that NTx is mostly released from bone matrix when bone resorption is accelerated. When premenopausal women were divided into two age groups and postmenopausal women were divided into two groups according to years since menopause (YSM) there were significant differences in LP and NTx between women <4 YSM and women aged <40 and those women aged 41+ (P < 0.01 and P < 0.05, respectively). A significant 110% increase in urinary NTx and a 48% increase in urinary LP were observed in postmenopausal women compared with age-matched premenopausal women aged 45–55. All biochemical markers other than serum PTH correlated significantly with each other (r = 0.243–0.858, P < 0.05–0.0001). Urinary NTx inversely correlated with lumbar spine BMD. When postmenopausal women were divided into three groups, the correlation between bone resorption and formation markers in women 0-1 YSM was greater than in women 2–10 YSM and in women 11 + YSM, indicating that resorption and formation are coupled at the early postmenopausal period. We conclude that urinary NTx is responsive to changes in bone metabolism caused by estrogen deficiency and may be a more sensitive and specific marker than HP, LP, or OH-Pr in the early postmenopausal years. Received: 15 February 1995 / Accepted: 18 October 1996     

Estrogenic regulation of HSP90 kD synthesis in rat urinary bladder

The role of heat shock protein (HSP90 kD) has been investigated in regard to its association with steroid receptors. HSP90 kD may play a role in steroid receptor stabilization and activation. Oophorectomized Sprague-Dawley rats (n = 25) were placed into five groups and injected subcutaneously with 30 microg beta-estradiol 17-benzoate in sesame oil, with one group injected with carrier oil (control). After estrogen administration, the rats were killed, and their bladders removed for immunostaining, immunoblotting and enzyme-linked immunosorbent assay (ELISA). Immunoblot analysis demonstrated a 90-kD band in bladder homogenates, even in the absence of estrogen. However, the bands were more intense 12 and 24 h after administering estrogen. ELISA showed significant differences in HSP90 kD synthesis as early as 6 h compared to controls (P< 0.05). After 48 h the estrogen-treated rats and controls were identical. The above results were confirmed by immunostaining for HSP90 kD. HSP90 kD synthesis in the rat urinary bladder is under estrogenic regulation. These findings may be relevant in the etiology and pathobiology of interstitial cystitis and menopausal voiding dysfunctions since the bladder is enriched with estrogenic receptors and is under estrogenic influence.     

Parathyroid hormone-related protein (1-34) and urothelial redifferentiation in the neuropathic urinary bladder

STUDY DESIGN: A comparative study of immunostaining for parathyroid hormone-related protein (1-34) (PTHrP (1-34)) in the vesical epithelium of biopsies obtained from patients with non-neuropathic bladder and those with neuropathic bladder. OBJECTIVES: To investigate the immunostaining for PTHrP (1-34) in the control cases and in neuropathic bladders showing (1) normal transitional epithelium, (2) hyperplastic transitional epithelium, and (3) squamous metaplasia. SETTING: Regional Spinal Injuries Centre, and Department of Cellular Pathology, Southport & Ormskirk Hospitals NHS Trust, Southport, Department of Pathology, Royal Liverpool University Hospital and the Departments of Clinical Chemistry and Cell Biology, The University of Liverpool, Liverpool, England. METHODS: Cold cup biopsies of bladder mucosa were taken from patients suffering from neuropathic urinary bladder when they were undergoing a therapeutic procedure in the urinary tract. Immunohistochemistry was performed on these biopsy specimens using a rabbit polyclonal antibody raised to a synthetic peptide corresponding to human PTHrP (1-34). Control group (n=10) consisted of archival biopsies taken from non-neuropathic bladders. Results: In the control group, the transitional epithelium showed no immunostaining, or at the most, very faint positive staining was seen in the transitional epithelium of non-neuropathic bladder. Positive immunostaining to PTHrP (1-34) was seen in the normal transitional epithelium of neuropathic bladder in nine of 13 cases. Hyperplastic transitional epithelium showed positive immunostaining for PTHrP (1-34) in 11 of 13 biopsies from patients with neuropathic bladder. Immunostaining for PTHrP (1-34) was observed in the metaplastic squamous epithelium in 14 of 17 cases with neuropathic bladder. CONCLUSION: The transitional epithelium of non-neuropathic bladder showed no immunostaining, or at the most, very faint positive staining for PTHrP (1-34). In contrast to this, positive immunostaining for PTHrP (1-34) was observed more frequently in the vesical epithelium of neuropathic bladder. This observation opens up avenues for innovative therapy with PTHrP or its analogues for possible modulation of urothelial differentiation in the neuropathic bladder.     

Urinary pyridinoline and deoxypyridinoline as bone metabolic markers in predicting therapeutic effects of estrogen and alfacalcidol in women with osteoporosis

The purpose of the present study was to evaluate the clinical usefulness of urinary pyridinoline (Pyr) and deoxypyridinoline (Dpyr) in predicting therapeutic effects of estrogen and alfacalcidol (1α-D₃) in patients with postmenopausal osteoporosis. We measured urinary excretion of Pyr and Dpyr, and determined bone mineral density (BMD) using a dual-energy x-ray absorptiometry in 48 women with osteoporosis (average age, 55.9 ± 8.4 years). Patients were treated with estrogen (HRT, n = 13), 1α-D₃ (n = 20), or calcium alone (n = 15). Baseline mean levels of urinary Pyr and Dpyr were significantly higher in the 48 patients compared to those in the age-matched postmenopausal women. The levels of urinary Pyr and Dpyr were inversely correlated with BMD. After treatment with estrogen or 1α-D₃, a significant decrease of urinary Pyr and Dpyr was observed, and elevated urinary Pyr and Dpyr were reduced to the level in premenopausal women. A significant inverse correlation was found in Pyr and Dpyr at 6 months and in lumbar BMD after 24 months of treatment (r = −0.43 to −0.52; P < 0.01). We concluded that urinary Pyr and Dpyr have clinical utility for predicting response to estrogen and 1α-D₃ therapy of osteoporosis patients. Received: July 28, 1998 / Accepted: Nov. 11, 1998     

Is the metabolic syndrome a risk factor for female sexual dysfunction in sexually active women?

Despite of the high prevalence, pathogenesis of female sexual dysfunction (FSD) is still poorly understood. A consecutive series of sexually active women underwent a health investigation and completed a questionnaire on FSD. Metabolic syndrome (MS) was defined according to the International Diabetes Federation definition. A total of 538 women with a mean age of 44 years (range: 30-69) was analysed. The premenopausal group comprised 329 women (61.2%) with a mean age of 38.5 years; the postmenopausal cohort contained 209 women (38.8%) with a mean age of 52.7 years. In the total cohort (n=538) MS was present in 17.6%, 8.5% in the premenopausal group and 32.6% in the postmenopausal women. In premenopausal women, the MS was an independent risk factor for impaired sexual desire (P=0.03) with an age-adjusted odds ratio of 3.3 (95% confidence interval: 1.5-7.3). In premenopausal female sexual life, the MS represents an independent role via its correlation to impaired desire.