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The impact of surgical menopause on lipid profile and hormonal status in women of reproductive age

Mon, 01 Jan 2024 00:00:00 GMT

Title: The impact of surgical menopause on lipid profile and hormonal status in women of reproductive age Authors: Vatamanu, Eleonora; Cerneţchi, Olga Abstract: The study of hormonal and metabolic disturbances following hysterectomy with or without ovariectomy is of great interest to gynecologists, because hysterectomy remains one of the most common types of gynecologic interventions in most countries and represents the treatment of choice for benign pathologies. The aim of the study was to determine the impact of surgical menopause on lipid profile and hormonal status in women of reproductive age. The current study is based on a prospective, observational analysis of 30 cases of hysterectomy without ovariectomy (group I, mean age 41.9 ±4.8 years) and 30 cases of hysterectomy with bilateral ovariectomy (group II, mean age 46.1 ±2.9 years). The control group consisted of 30 healthy women of similar age to those included in the research groups. Serum level of estradiol (E2), total cholesterol, triglycerides, HDL-C and LDL-C were evaluated preoperatively, on the 10th-12th postoperative day, 6 and 12 months after the intervention. The lipid profile analysis showed a significant increase in the mean total cholesterol level from 3.91 ±0.37 mmol/l preoperatively to 4.18 ±0.43 mmol/l 12 months postoperatively in group I and from 4.11 ±0.32 mmol/l to 4.28 ±0.21 mmol/l in group II (p<0.05). These values were significantly higher compared to the control group (3.92 ±0.59 p<0.05). Also, the results of our study reveal that the serum level of triglycerides at 12 months postoperatively was significantly higher in both groups (1.85 ±0.25 mmol/l in group I and 1.82 ±0.16 mmol/l in group II) compared to the control group (1.63 ±0.17 mmol/l), p<0.05. The increase in serum LDL-C level as well as the decrease in HDL-C was more evident in women who underwent hysterectomy with bilateral ovariectomy. This could probably be explained by a more pronounced decrease in the level of E2 in this group. Thus, the serum E2 level one year postoperatively in group I was 121.90 ±8.63 pg/ml and in group II 102.76 ±7.88 pg/ml, being significantly lower compared to the group of control (142.06 ±12.70 pg/ml) p<0.05. Hysterectomy led to a decrease in the serum level of estradiol and to disturbances in the lipid profile in the first postoperative year. These changes were more evident in patients with bilateral ovariectomy. Early diagnosis and individualized treatment can prevent hormonal decline, the appearance of complications and can also maintain the quality of life in this category of patients.

Assessment of the role of APRI index in women with intrahepatic cholestasis of pregnancy

Sun, 01 Jan 2023 00:00:00 GMT

Title: Assessment of the role of APRI index in women with intrahepatic cholestasis of pregnancy Authors: Cemortan, Maria; Cerneţchi, Olga; Iliadi-Tulbure, Corina; Sagaidac, Irina Abstract: Introduction. Intrahepatic cholestasis of pregnancy (ICP) is a condition characterized by increased liver function tests and the presence of cutaneous pruritus. The aspartate aminotransferase to platelet ratio index (APRI) has been shown to be a useful tool in diagnosing and predicting the progression of liver cirrhosis and fibrosis. At the same time, there are few studies, which would focus on the assessment of APRI level in women with ICP. Material and Methods. In a prospective study 71 clinical cases complicated by ICP (group A) were compared to 71 cases without ICP (group B). The APRI was calculated using the formula: {(AST/upper limit of the normal values) x 100}/ number of platelets (109/L). The arithmetic means and standard deviation (M (SD)) were calculated, a t-test to compare two means was applied. Besides that, Pearson’s correlation was assessed. Results. Mean values of APRI in group A were 1.2 (1.2) compared to group B – 0.3 (0.1), 95% CI 0.61 - 1.18, p˂0.0001. By analyzing the correlation between APRI and indicators assessed in the study a negative correlation with term of pregnancy at which delivery occurred (p=0.01) and with delivery duration (p=0.01) was identified. Positive correlation was also found with the presence of meconium-stained amniotic fluid (p=0.01), caesarean section rate (p=0.01) and the amount of postpartum blood loss in women recruited in the study (p=0.01). Conclusions. The results of our study revealed the correlation between APRI value and the presence of specific conditions related to pregnancy, that may be an important step in the management of cases of ICP.

Message of the first vice-rector

Thu, 01 Jan 2026 00:00:00 GMT

Title: Message of the first vice-rector Authors: Cerneţchi, Olga

Surgical menopause in reproductive women

Wed, 01 Jan 2020 00:00:00 GMT

Title: Surgical menopause in reproductive women Authors: Cerneţchi, Olga; Vataman, Elena Abstract: Introduction. Surgical menopause is an issue with increasing significance in clinical practice due to its high frequency and increased morbidity. The aim of the study was to review the relevant literature data on surgical menopause in women of reproductive age. Materials and method. We performed a review of the currently available data in the PubMed database regarding the hormonal status and the effects of surgically induced menopause on women’s health. The keyword used for the search was “surgical menopause”. Results. Surgical menopause is a condition with the cessation of menstrual function that occurs in ovarectomy without hysterectomy, or ovarectomy with hysterectomy, or hysterectomy with the preservation of one or both ovaries, or after ovarian resection. In the case of the first two types, a severe estrogen deficiency occurs, and the first symptoms of surgical menopause develop very quickly, the vasomotor symptoms appearing already in the first two days after surgery. In case of hysterectomy with ovarian retention, in most women the symptoms of menopause appear gradually and seem to be similar but less dramatic compared to the first two cases. Studies show that surgical menopause involves serious health changes, including decreased bone density, cardiovascular disease, metabolic disorders, and mental health problems. Conclusions. Surgical menopause leads to a series of endocrine-metabolic, neurovegetative and psychoemotional disorders, due to the estrogen deficiency, which determines the need for an early diagnosis and the use of hormone replacement therapy.