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

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.