Sexual Assault Nurse Examiner (SANE) A Practice Exam

What physiological change in elderly women is primarily caused by decreased estrogen?

1. Increased bone density

2. Altered vaginal wall and dryness

3. Growth of body hair

4. Enhanced muscle mass

The correct answer is: Altered vaginal wall and dryness

Decreased estrogen in elderly women leads primarily to changes in the vaginal tissue and related structures, resulting in altered vaginal walls and dryness. This hormonal change occurs during menopause, a time when the ovaries significantly reduce their production of estrogen. Estrogen is crucial for maintaining the health and elasticity of the vaginal walls, as well as for overall vaginal lubrication. As estrogen levels drop, women may experience a thinning of the vaginal epithelium, which can lead to reduced moisture and elasticity. These physiological changes are part of a broader series of bodily adjustments that women experience during menopause, impacting their overall urogenital health. The lack of estrogen can cause symptoms such as vaginal dryness, itching, and discomfort during intercourse, which are all linked to these changes in the vaginal wall. In contrast, the other options reflect physiological changes that are either less relevant or not caused by decreased estrogen. For instance, increased bone density is generally not seen with decreased estrogen; instead, lower estrogen levels contribute to a decrease in bone density, increasing the risk for osteoporosis. Likewise, changes in body hair growth and increased muscle mass are generally not linked to the decreased estrogen that occurs in postmenopausal women. Thus, the option indicating altered vaginal wall and dryness accurately captures the primary physiological