Jemimah T. Cartagena,
Ma. Carmen H. Quevedo
Department of Obstetrics an Gynecology - Jose R. Reyes Memorial Medical Center
Surgical menopause takes place upon removal of functioning ovaries in a woman who has not yet reached menopause. In most cases, surgical removal of the ovaries is indicated in the context of ovarian pathologies. In other cases, however, they are removed electively together with hysterectomy on the basis of advancing age in an effort to decrease incidence of ovarian cancer. This is done with the premise that there is little advantage for ovarian preservation since the woman will be nearing menopause. In the context of elective oophorectomy, ovarian cancer risk which has only a lifetime risk of 1.4% in the general population, is avoided. However, subjecting women to surgical menopause accelerates onset of acute menopausal symptoms and has serious long-term health consequences.
Obesity has been thought to be protective against menopausal symptoms due to peripheral conversion of estrogen. However, there have been studies which showed association between vasomotor symptoms and increased adiposity.
Participants include patients who underwent hysterectomy with bilateral salpino-oophorectomy in Jose R. Reyes Memorial Medical Center. Subjects were given Menopause Quality of Life (MENQoL) Questionnaire, which is a research tool to measure condition specific quality of life in early post-menopausal women. An inherent assumption of the MENQoL is that disease states and conditions like menopause, which produce symptoms, may disrupt emotional, physical, and social aspects of an individual's life. It consist of 29 items in a Likert-scale format. Each item assesses the impact of one of four domains of menopausal symptoms, as experienced over the last month: vasomotor (items 1-3), psychosocial (items 4-10), physical (items 11-26), and sexual (items 27-29). Body mass index was measured at the same visit together with accomplishment of the questionnaire.
Across all domains, those who experienced surgical menopause were reported to be more bothered by MENQoL symptoms compared to those who were already menopausal prior to surgery (P<0.0001). Overall, the odds of having vasomotor symptoms increased by 24% for every unit increase in BMI.
Surgical menopause had a greater impact on quality of life in terms of vasomotor, psychosocial, physical and sexual domains. Overall, elevated body mass index increased the odds of having vasomotor symptoms in both groups.
The primary aim of this study is to investigate the effects of preoperative reproductive status on vasomotor symptoms and quality of life of women following hysterectomy with bilateral salpino-oophorectomy and to examine its association with increase body mass index.
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