A major reason for the atrophic changes that occur in the pelvic floor muscles of the elderly woman is:

Question

A. Diminished levels of estrogen
B. Increased levels of testosterone
C. Autonomic neuropathy
D. Decreased glycogen in the vagina

Answer 1

ANS: A
The most significant age-related changes in women are related to decreased estrogen influence. As estrogen levels decline, the epithelium and supporting tissues of the pelvis atrophy, resulting in friable mucosa and possible prolapse of the pelvic structures. The change in relationship of the pelvic structures results in hypermobility of the bladder base, pelvic muscle weakness, and urethral weakness, resulting in stress UI in women. The decreased glycogen content of the vaginal epithelium causes decreased lactic acid metabolism by Döderlein's bacillus, an increased pH of vaginal secretions, and, therefore, an increased risk for UTI.