A new prospective case-control study suggests salivary free testosterone may serve as a non-invasive biomarker for pelvic organ prolapse in postmenopausal women. The research indicates a hormonal link with both the development and severity of this common pelvic floor disorder.
Researchers at Saga University Hospital enrolled 109 postmenopausal women with pelvic organ prolapse and 66 age-matched controls. They assessed pelvic floor status using the Pelvic Organ Prolapse Quantification system and measured salivary free testosterone, 17β-estradiol, and serum DHEA-S.
Women with pelvic organ prolapse had significantly higher BMI and parity compared with controls, along with more severe lower urinary tract symptoms. Hormonal analysis showed a significant reduction in salivary free testosterone in the prolapse group, while serum DHEA-S levels were unexpectedly elevated. Estradiol levels did not differ significantly.
More advanced prolapse stages were associated with further reductions in salivary free testosterone, suggesting a potential link between androgen deficiency and disease severity. The pattern of elevated DHEA-S in certain stages was noted but remains clinically unclear.
Study authors caution that causality cannot be established due to the observational design. They call for larger, longitudinal studies to validate salivary free testosterone as a clinically useful biomarker. If confirmed, this approach could enable earlier identification of at-risk women and guide future preventive strategies in postmenopausal care.