Clinical profile of 550 cases of surgical and natural menopause

Background: Menopause represents the permanent cessation of menstrual periods and the loss of fertility due to the loss of ovarian function. It can occur spontaneously (natural menopause) or it can be surgically induced. They are different entirely. One is a natural stage of life that all women experience, the other is the result of surgery, that is, bilateral oophorectomy. Surgical menopause is when surgery, rather than the natural aging process, causes a woman to go through menopause. The ovaries are the main source of estrogen production in the female body. Their removal triggers immediate menopause, despite the age of the person having surgery. While surgery to remove the ovaries can operate as a stand-alone procedure, it is sometimes performed in addition to hysterectomy to reduce the risk of developing chronic diseases. This study was designed to compare the effects of the natural and the surgical menopause. Methods: This prospective observational study was conducted in the Department of Obstetrics and Gynaecology of Z. H. Sikder Women’s Medical College & Hospital, Dhaka from January 2016 to December 2018. During the study period a total of 275 patients with surgical menopause (total abdominal hysterectomy with bilateral salpingo-oophorectomy was done in all cases) and 275 patients with natural menopause were enrolled. After taking written consent detailed information about the patients was collected in a predesigned data collection sheet for each patient. Results: Age of most of the patients in surgical menopause group was within 41 to 50 years and most patients were >50 years old in natural menopause group. Most of the patients were illiterate in both groups and maximum patients were in poor socio-economic condition in both groups. Hot flush (48.0% vs 28.0%), palpitation (28.0% vs 4.0%) and dryness of vagina (12.0% vs 0.0%) were higher and body ache (32.0% vs 48.0%), tiredness (8.0% vs 36.0%), insomnia (8.0% vs 28.0%), depression (4.0% vs 16.0%), lack of concentration (0.0% vs 4.0%), loss of memory (0.0% vs 16.0%) and irritability (4.0% vs 8.0%) were found significantly lower in surgical menopause than natural menopause group. Dyspareunia (72.0% vs 28.0%), dysuria (92.0% vs 40.0%) and increased frequency of urination (68.0% vs 36.0%) were significantly higher in surgical menopause than natural menopause group. Urgency, hesitancy and incontinence of urination were significantly lower in surgical menopause than natural menopause group. Conclusion: Ovaries were removed in all of the surgical menopause cases, which may be the reason of more deleterious effects in surgical menopause than natural menopause. So, it is highly recommended to preserve ovaries in hysterectomies due to benign indications. Birdem Med J 2020; 10(3): 168-171

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Is There any Difference of Climacteric Symptoms between Natural and Surgical Menopause?

The Journal of South Asian Federation of Menopause Societies ◽

10.5005/jp-journals-10032-1014 ◽

2013 ◽

Vol 1 (2) ◽

pp. 63-65

Author(s):

Shaikh Zinnat Ara Nasreen ◽

Shafinaz Shahreen ◽

Shahnaz Rahman

Keyword(s):

Hormone Replacement ◽

Total Abdominal Hysterectomy ◽

Abdominal Hysterectomy ◽

Menopausal Symptoms ◽

Climacteric Symptoms ◽

Natural Menopause ◽

Treatment Of Osteoporosis ◽

Surgical Menopause ◽

Spss Software ◽

Poor Memory

ABSTRACT Objective To compare the effects of the natural and the surgical menopause (SM) on climacteric condition. Materials and methods This prospective study was conducted from Jan 2008 to Jan 2013 in ZHSWMCH. Initially, 4,000 women were enrolled but finally 1,743 of natural menopause (NM) and 554 of SM were analyzed. All women were aged between 45 and 50 years, and they were of menopause for 1 to 5 years. Ethical and patient's permission was taken. Once enrolled, they were asked questions. The questions were related to menopausal symptoms (MS). Data was collected and analyzed by SPSS software. Results Hot flushes, (535 vs 290, p < 0.001), sweating (344 vs 122, p < 0.001), poor memory (99 vs 65 p < 0.001), feeling depressed (335 vs 126, p < 0.001), dry skin/mucosa (229 vs 91, p < 0.001), decreased libido (289 vs 117, p < 0.001), dry vagina (99 vs 65, p < 0.001) and urinary complains (59 vs 42, p < 0.001) were found in SM vs NM. Hypertension or cardiovascular disease was more (191 vs 92, p < 0.01), blood sugar were more (90 vs 32, p ≤ 0.001) and metabolic syndrome are also more (48 vs 26, p < 0.07) in SM than NM but this did not reach the significance. Conclusion Menopausal symptoms are common in both NM and SM. These MS were significantly higher in surgically menopause women and they were troubled more, so we need to be cautious about oophorectomy, and ovarian preservation should be the aim in all benign cases. Of course, we need to assess the risks and benefit where there is risk of ovarian cancer during the time of total abdominal hysterectomy. Both hormone replacement therapy (HRT) (following a risk/benefit analysis) and treatment of osteoporosis may be recommended after surgery to decrease the climacteric symptoms and osteoporosis in women with menopausal symptoms. How to cite this article Nasreen SZA, Shahreen S, Rahman S. Is There any Difference of Climacteric Symptoms between Natural and Surgical Menopause? J South Asian Feder Menopause Soc 2013;1(2):63-65.

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Comparison of 550 cases of surgical and natural menopause in respect to Genito-urinary Syndrome of Menopause (GSM)

Z H Sikder Women’s Medical College Journal ◽

10.47648/zhswmcj.2020.v0102.05 ◽

2019 ◽

Vol 1 (Number 2) ◽

pp. 19-21

Author(s):

Nusrat Mahjabeen ◽

Sk. Zinnat Ara Nasreen

Keyword(s):

Observational Study ◽

Sampling Method ◽

Prospective Observational Study ◽

The Other ◽

Natural Menopause ◽

Medical College ◽

Obstetrics And Gynaecology ◽

Data Collection Sheet ◽

Hot Flush ◽

Surgical Menopause

Natural menopause and surgical menopause are used interchangeably when conditions of patients are discussed. But they are different entirely. One is a natural stage of life that all women experience, the other is the result of surgery. This prospective observational study was conducted in the Department of Obstetrics and Gynaecology, Z.H. Sikder Women’s Medical College & Hospital, Dhaka from January 2016 to December 2018 over a period of three years to compare the GSM effects in natural and surgical menopause cases. During the study period a total of 275 patients with surgical menopause and 275 patients with natural menopause were enrolled employing purposive sampling method using a predesigned data collection sheet. Age of the most of the patients in surgical menopause group was within 41 to 50 years and most of the patients were >50 years old in natural menopause group. Most of the patients were illiterate in both groups and maximum patients were poor in both groups. Hot flush (48.0% vs 28.0%), dryness of vagina (12.0% vs 0.0%) and dyspareunia (72.0% vs 28.0%) were found significantly higher in surgical menopause than natural menopause. Dysuria (92.0% vs 40.0%) and increased frequency of urination (68.0% vs 36.0%) were significantly higher in surgical menopause than natural menopause group. Urgency, hesitancy and incontinence of urination were significantly lower (p=<0.001) in surgical menopause than natural menopause group. In most of the surgical menopause cases, ovaries were also sacrificed. And this may be the reason of more deleterious effects in surgical menopause than natural menopause. So, it is highly recommended to preserve ovaries in hysterectomies due to benign indications.

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Surgical menopause: A toolkit for healthcare professionals

Post Reproductive Health ◽

10.1177/20533691211038455 ◽

2021 ◽

pp. 205336912110384

Author(s):

Akanksha Garg ◽

Lynne Robinson

Keyword(s):

Healthcare Professionals ◽

Ovarian Function ◽

Hormone Replacement ◽

Bilateral Oophorectomy ◽

Natural Menopause ◽

Sudden Loss ◽

Increased Risk ◽

Surgical Menopause ◽

Loss Of Libido

Surgical menopause (bilateral oophorectomy) is commonly undertaken during a hysterectomy to treat various medical conditions. Menopausal symptoms can be particularly severe due to the sudden loss of ovarian function. This clinical toolkit is intended to guide healthcare professionals caring for women undergoing surgical menopause. Women commonly experience vasomotor symptoms, sexual dysfunction and an increased risk of cardiovascular and osteoporotic disease. Compared with a natural menopause, loss of libido can be more pronounced following a surgical menopause. Hormone Replacement Therapy (HRT) plays a significant role in managing surgical menopause, especially in women aged under 45 years old. All women undergoing surgical menopause should have adequate counselling regarding the hormonal consequences of surgery and the role of HRT with a view to provide individualised, patient-centred care.

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HISTOMORPHOLOGICAL SPECTRUM OF LESIONS OF HYSTERECTOMY SPECIMENS IN GCS MEDICAL COLLEGE, HOSPITALAND RESEARCH CENTER, AHMEDABAD : A STUDY OF 100 CASES

10.36106/ijsr/2320116 ◽

2020 ◽

pp. 80-82

Author(s):

Shweta Shah ◽

S.K. Suri ◽

Ami Shah

Keyword(s):

Retrospective Study ◽

Age Groups ◽

Total Abdominal Hysterectomy ◽

Abdominal Hysterectomy ◽

Medical College Hospital ◽

Research Centre ◽

Age Group ◽

Gynaecological Surgery ◽

College Hospital ◽

Medical College

Background: Most frequently performed gynaecological surgery is hysterectomy. The prevalence of hysterectomy varies within different regions. There are mainly two types of hysterectomies according to which part of uterus is removed. The main types of hysterectomy are total and subtotal or partial hysterectomy. The hysterectomy can be performed by three routes abdominal, laproscopic and vaginal hysterectomy. The main objective of our study is to know most common pathology and different age groups of the patients underwent hysterectomy. Materials and Methods: In this retrospective study was carried during period 6 months, at GCS medical college, hospital and research centre, Ahmedabad. Total 100 hysterectomy specimens were analyzed for histopathological lesions. We had taken the clinical and histopathological findings of these cases from the records of department of pathology, GCS medical college , hospital and research centre. Results: In our study of 100 cases, most common age group underwent hysterectomy was 40-49 years and least common age group was 20-29 years. Type of hysterectomy performed most commonly in this study was total abdominal hysterectomy with bilateral salpingoophorectomy. Most of lesions were seen in the myometrium 42 cases (42%), Endometrium 32 cases (32%), Cervix 16 cases (16%) and Ovary 10 cases (10%). Hysterectomy remains the widely used treatment modality.

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Clinical evaluation of total abdominal hysterectomy - a prospective study in a tertiary care hospital

Northern International Medical College Journal ◽

10.3329/nimcj.v6i2.23178 ◽

2015 ◽

Vol 6 (2) ◽

pp. 76-77

Author(s):

Shirin Akhter ◽

Rumana Nazneen

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Total Abdominal Hysterectomy ◽

Abdominal Hysterectomy ◽

Care Hospital ◽

College Hospital ◽

Cross Sectional ◽

Medical College ◽

Before And After ◽

A Prospective Study

Total abdominal Hysterectomy are gradually rising in our country. This study has been designed to find out the common indications of abdominal hysterectomy in a tertiary care hospital,. to know the clinical characters of the patients and. o elucidate postoperative complication of abdominal hysterectomy.Methodology : Cross- sectional observational study was done during 1st October 2007 to 30th September 2008. Holy Family Red Crescent Medical College Hospital (HFRCMCH). Total 100 patients were selected following enclusion & exclusion criteria hyperposive sampling. Data were recorded before and after operation and analyzed by SPSS version 15.Result : In the present study patients with leiomyoma of uterus was found to be the major indication of hysterectomy followed by dys functional uterine bleeding (DUB) 18.0%, Pelvic inflammatory disease (PID) 14.0%, chronic cervicitis 10.0%, adenomyosis 10.0%, pelvic endometriosis 6.0%, cervical polyp 2.0%, ovarian cysts 1.0% and chriocarcinoma 1.0%. Mean duration of operation (hour) and hospital stay was 1.15 hours and 7.48 days respectively. Most common complication of present series was fever 20.0% followed by 13.0% had wound infection, 6.0% UTI and 2.0% wound dehiscence.Conclusion : Hysterectomy is now the most widely performed major operation in gynaecology. Indication and post operative complications of hysterectomy varies from region to region.Northern International Medical College Journal Vol.6(2) 2015: 76-77

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Uterine Myoma: A Profile of Nepalese women

Nepal Journal of Obstetrics and Gynaecology ◽

10.3126/njog.v1i2.2397 ◽

1970 ◽

Vol 1 (2) ◽

pp. 47-50

Author(s):

Pramila Pradhan ◽

Nitish Acharya ◽

Binit Kharel ◽

Manoj Manjin

Keyword(s):

Abdominal Mass ◽

College Teaching ◽

Total Abdominal Hysterectomy ◽

Abdominal Hysterectomy ◽

Early Marriage ◽

Early Completion ◽

Medical College ◽

Underlying Risk Factor ◽

The Mean ◽

Myoma Uteri

Objectives: To determine the most common age and parity for the development of myoma uteri. To find out any relation between age of the last child and the development of myoma uteri. To determine the treatment protocal and outcome of treatment. Materials/methods: This study was carried out at Nepal Medical College Teaching Hospital from Jan 2001 to 31st June 2006. All cases of myoma uteri admitted in Gynaecological ward was included.. Histological evidence of myoma confirmed the diagnosis. Age, parity and age of the last child, clinical features, surgical procedures and outcome of surgery were considered. Results: A total of 137 cases of myoma uteri was operated during five and half years period. This represented 38.5 %of all abdominal hysterectomy performed during the same period. The mean age was 43.3 years with median parity at 1-3 and the mean age of last child at 12years. Excessive menstrual bleeding 73.0%, abdominal mass and pain 58.4%, dysmenorrhea 18.2% and infertility 7.3% were the common symptoms. Total abdominal hysterectomy was the mainstay of treatment. Patients were happy with the treatment specially those with severe and multiple symptoms Postoperative complications were not significant. There was one death due to pulmonary embolism who had mesothelioma of pleura diagnosed by pleural biopsy before operation. Conclusion: Early marriage and early completion of the family is the social trend in Nepalese society. Myoma is common in 4th-5th decade of life in multi parity with the age of last child around 12years. This long standing secondary infertility may be an underlying risk factor in the development of myoma uteri. doi:10.3126/njog.v1i2.2397 N. J. Obstet. Gynaecol Vol. 1, No. 2, p. 47-50 Nov-Dec 2006

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DETERIORARON OF OVARIAN FUNCTION AFTER TOTAL ABDOMINAL HYSTERECTOMY WITH PRESERVARON OF OVARIES

Endocrine Practice ◽

10.4158/ep161215.or ◽

2016 ◽

Vol 22 (12) ◽

pp. 1387-1392 ◽

Cited By ~ 4

Author(s):

Arijit Singha ◽

Sudipta Saha ◽

Rana Bhattacharjee ◽

Samim Mondal ◽

Subhadip Choudhuri ◽

...

Keyword(s):

Ovarian Function ◽

Total Abdominal Hysterectomy ◽

Abdominal Hysterectomy

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Effect of surgical menopause on serum lipid profile-a prospective study

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20175519 ◽

2018 ◽

Vol 5 (1) ◽

pp. 27 ◽

Cited By ~ 1

Author(s):

Renymol B. ◽

Ambili N. R. ◽

T. D. Unnikrishnan Kartha

Keyword(s):

Blood Pressure ◽

Cardiovascular Risk ◽

Lipid Profile ◽

Ovarian Function ◽

Tertiary Care ◽

Anthropometric Measurement ◽

College Hospital ◽

Medical College ◽

Surgical Menopause ◽

A Prospective Study

Background:Menopause marks the onset of cessation of ovarian function which is associated with changes in cardiovascular risk factors especially an unfavourable change in lipid profile. This is more pronounced is perimenopausal females who have undergone total hysterectomy with bilateral sapingo oopherectomy. This study aimed at looking into the changes occurring in the lipid profile and other cardiovascular risk in patients who have underwent oopherectomy over a 3 months period.Methods: The study was conducted as a case control one. We studied 70 consecutive perimenopausal patients admitted in a tertiary care teaching medical college hospital in Kerala, South India who were admitted for hysterectomy and bilateral oopherectomy over a 1year period. The lipid profile and anthropometric measurement with blood pressure recording was done prior to surgery and the same patients were followed up after 3 months when the cardiovascular risk assessment and lipid profile estimation were repeated. Here, the cases acted as controls after the end of third month.Results: It was found that after the end of 3 months of surgical menopause there was no significant change in body mass index, waist hip ratio or systolic BP. However, the DBP was higher in patients after surgery (78.68±7.94 vs 83.31±11.03, P <0.001). There was also statistically significant increase in total cholesterol (166.07±28.22 vs 242.94±45.65 [P<0.001]), TG (129.33±31.16 vs 177.06±50.57 P<0.001) and LDLc (107.83±20.06 vs 166.73±48.51 P>0.001). The HDLc was found to be 27% after 3 months of surgical menopause (59.31±8.22 vs 43.73±35 P>0.001.Conclusions: Thus, it was concluded that there was a significant unfavourable effects on lipid profile and diastolic blood pressure 3 months after surgical menopause.

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Abstract MP25: Is Surgical Menopause Associated With Future Cardiovascular Risk Factors Independent Of Antecedent Levels? The Cardia Study

Circulation ◽

10.1161/circ.129.suppl_1.mp25 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Duke Appiah ◽

Pamela J Schreiner ◽

Julie K Bower ◽

Barbara Sternfeld ◽

Cora E Lewis ◽

...

Keyword(s):

Risk Factors ◽

Rate Of Change ◽

Cvd Risk Factors ◽

Bilateral Oophorectomy ◽

Cvd Risk ◽

Natural Menopause ◽

Mean Values ◽

Index Visit ◽

Surgical Menopause

Objective: The aim of this study was to compare changes in selected CVD risk factors prior to and after natural or surgical (hysterectomy with or without bilateral oophorectomy) menopause. Methods: Data were obtained from women aged 18 to 30 years at baseline without hysterectomy enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study and followed for 25 years. Piecewise linear mixed effects models were used to examine changes in waist circumference (WC) and HDL-cholesterol (HDL-c) from baseline to index visit (first visit after the date of natural or surgical menopause) and after index visit to the end of observation. Results: During follow up, 639 women reached natural menopause (NM), 304 reported hysterectomy with one or both ovaries conserved (HO) and 153 reported hysterectomy with bilateral oophorectomy (HBO). Baseline mean values of WC were 73.9, 76.4, 75.9 cm, p=0.005 for NM, HO, and HBO respectively while those for HDL-c were 57.6, 54.6, 54.2 mg/dL, p=0.001. After adjustment for race, education, field center, traditional CVD risk factors, lipid-lowering medication, age at and time since menopause, the mean values of WC at the index visit were 88.8, 92.4, 92.0 cm, p=0.001 for NM, HO, and HBO respectively while those for HDL-c were 61.5, 57.0, 57.8 mg/dL, p=0.006. Compared to women with natural menopause, surgically menopausal women (regardless of ovarian status) had higher annual rate of change for WC (0.74 vs. 0.63 cm, p=0.002) as well as lower rate of change for HDL-c (0.15 vs. 0.30 mg/dL, p=0.001) from baseline to index visit. No statistically significant differences in the annual rate of change after index visit to the end of follow up were observed between these two groups for either WC or HDL-c. Conclusion: While surgical menopause is commonly believed to worsen CVD risk, in this population-based sample, we found that women who undergo hysterectomy with or without bilateral oophorectomy had more adverse values for central adiposity and lipids at baseline compared to women with natural menopause. However, antecedent risk factor levels were strongly associated with postmenopausal levels in all women.

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