Oestrogen, the key to a healthy pelvic floor?

This thesis integrates both clinical and preclinical research to investigate the therapeutic potential of oestrogen therapy and vaginal CO₂ laser therapy for postmenopausal conditions such as pelvic organ prolapse (POP) and genitourinary syndrome of menopause (GSM). It explores the role of oestrogen therapy in vaginal wound healing and its impact on surgical outcomes following POP surgery, addressing the ongoing debate on its clinical benefits. Additionally, this thesis validates the ovariectomised ewe as a model for GSM by assessing serum oestrogen levels, histological parameters, and vaginal microcirculation. Furthermore, it evaluates vaginal CO₂ laser therapy as a non-hormonal alternative to oestrogen, and comparing its effects to vaginal oestrogen therapy. By integrating preclinical and clinical findings, this research enhances our understanding of postmenopausal vaginal health and informs evidence-based therapeutic strategies for both surgical and non-surgical management of POP and GSM.