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There’s tons of research discussing the important role of estrogen and androgens on female urogenital health. Here’s excerpts from a couple sources to get you started, highly recommend doing your own searches to understand more how important these hormones are and how HRT has been found to ameliorate many of the symptoms of vulvodynia, interstitial cystitis, genitourinary syndrome of menopause, etc.
The Treatment of Vestibulodynia with Topical Estradiol and Testosterone
https://pubmed.ncbi.nlm.nih.gov/25356...
Estrogen receptors in human bladder cells regulate innate cytokine responses to differentially modulate uropathogenic E. coli colonization
https://pubmed.ncbi.nlm.nih.gov/33246...
“While the reason for this has been debated, one well-regarded theory is that increased estrogen and decreased testosterone play a role in this predisposition. Interstitial cystitis (IC), also known as painful bladder syndrome (PBS), is an autoimmune disorder that affects over nine million women in the United States.”
“GENITOURINARY SYNDROME OF MENOPAUSE
Genitourinary syndrome of menopause (GSM), formerly known as vulvovaginal atrophy, is an umbrella term describing urinary, genital, and sexual dysfunction as a result of a decline in sex hormone levels. It affects up to 70% of postmenopausal women, and without treatment, symptoms tend to progress over time.40 Common symptoms of GSM include dyspareunia, vaginal dryness and irritation, dysuria, urinary frequency, urinary urgency, recurrent urinary tract infection, and alkaline shift in vaginal pH.39
Androgen and estrogen receptors are present in the vaginal mucosa, submucosa, stroma, smooth muscle (vaginal, urethral, and bladder), and vascular endothelium. In the vagina, androgens regulate vaginal mucin production in epithelial cells, improve blood flow by increasing nitric oxide, and influence neurotransmitter content and nerve density.41 There is a positive correlation between testosterone levels and volume of urethrovaginal tissue.39”
“Decisions to continue treatment are based on clinical response; hormone levels do not correlate with symptom burden, and testing is intended only to ensure safe delivery of treatment.
Clinicians should avoid diagnosing female androgen deficiency on the basis of hormonal testing, as the syndrome is not well defined, and interpreting androgen levels and their physiologic effects is complex.”
https://www.ccjm.org/content/88/1/35
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