Innervation and vascularization of vaginal mucosae from healthy post-menopausal women and post-menopausal women with diabetes and hypertension

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SUN 554-573-Ovarian & Uterine Function I
Sunday, June 16, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SUN-573
Maurizio Baldassarre1, Giulia Gava2, Ilaria Mancini2, Martina Lambertini2 and Cristina Maria Meriggiola*2
1S.Orsola-Malpighi, University Hospital, Bologna, Italy, 2University of Bologna, Bologna, Italy
Background. The vagina is a key organ in female sexual response and sexual dysfunction may be linked to altered vaginal structure and/or function. Recent evidence suggests increased prevalence of sexual dysfunction in the presence of cardiovascular risk factors such as diabetes and hypertension. Whether these factors act through direct vaginal effect is unclear.

Aims. To evaluate changes in the innervation and vascularization of the vaginal mucosae of post-menopausal women affected by diabetes and hypertension compared to healthy post-menopausal women.

Materials and Methods. Vaginal biopsies were obtained from healthy post-menopausal (Mc) (n=9) women and post-menopausal women with diagnosis of diabetes (Md) (n=9) or severe hypertension (Mh) (n=9), undergoing genital surgery. CD31 immunostaining was used to characterize the vaginal vascular bed while vaginal mucosa gene expression of the endothelial (eNOS) and neuronal (nNOS) nitroxyde synthase isoforms were determined by Real-Time PCR. Additionally vaginal protein expression of Protein Gene Product 9.5 (PGP9.5) and Tyrosine Hydroxylase (TH) were evaluated by Western Blot analysis.

Results CD31 immunostaining shows an increased vessel number in Mh and Md women (Mc:10,19±1,52; Md:10,85±0,51; Mh:14,11±1,04; P=<0.05) which are characterized by a reduced or absent vascular lumen as compared to Mc. Vaginal innervation as assessed by PGP9.5 staining was reduced in Md and Mh compared to Mc women (score: Mc:2,25±0,47; Md:1,70±0,17; Mh:1,01±0,12; P=<0.05). Mh women showed a slight increase in sympathetic innervation revealed by TH analysis (Mc:0,47±0,22; Md:0,44±0,26; Mh:0,78±0,20; P=n.s.). Both eNOS and nNOS gene expression were reduced in Md and Mh  compared to Mc women reaching statistical significance only in the Md group (eNOS - Mc:6,27±2,58; Md:0,30±0,09; Mh:3,39±1,25 - nNOS - Mc:2,65±0,97; Md:0,55±1,18; Mh:1,28±0,36).

Conclusion. Our results suggest that vaginal mucosae from Md and Mh presents changes in innervation and vascularization compared to Mc. These changes may be at least partially responsible for the increased sexual dysfunctions in these women.

Nothing to Disclose: MB, GG, IM, ML, CMM

*Please take note of The Endocrine Society's News Embargo Policy at

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