Objective: Androgens regulate biomechanical responses in load-bearing tissues. Evidence suggests that androgens may play a role in the cervix. We hypothesized that androgens directly regulate cervical remodeling by altering both collagen structure and proteoglycan composition.
Study design: Cervical resistance was evaluated using the cervical creep method after the administration of intravaginal dihydrotestosterone or oral flutamide. Microstructural changes in collagen were evaluated by transmission electron microscopy and polarized light birefringence. Proteoglycan expression was evaluated by reverse transcription-polymerase chain reaction for the core proteins (decorin, biglycan, fibromodulin, aggrecan, versican) and fluorophore-assisted carbohydrate analysis.
Results: Dihydrotestosterone decreased cervical resistance, whereas flutamide inhibited the decline in cervical resistance, compared with vehicle controls. Flutamide was associated with higher levels of organized collagen and increased aggrecan expression with a greater proportion of chondroitin/dermatan sulfate glycosaminoglycans. Flutamide inhibited the increase in hyaluronan.
Conclusion: Androgens appear to play a role in regulating cervical resistance by altering proteoglycan content. Structural analysis indicates that flutamide may alter collagen fibril organization and/or structure.