Effects of simple hysterectomy on bone loss

Simões, Rosana Durães; Baracat, Edmund Chada; Szjenfeld, Vera Lúcia; Lima, Geraldo Rodrigues de; Gonçalves, Wagner José; Bortoletto, Cláudia de Carvalho Ramos

doi:10.1590/s1516-31801995000600003

Cited by 20 publications

(13 citation statements)

References 9 publications

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“…17 Similar results were found by Ozkaya E et al in their study and found BMD to be significantly lower in Femur and Trochanter of posthysterectomised group compared to natural menopausal women. 18 In the present study, in 66 patients 30 were hysterectomised and 36 were non-hysterectomised.…”

Section: Discussionsupporting

confidence: 88%

“…Surgical menopause leads to earlier osteoporosis as studies have shown lower bone density in the lumbar spine and proximal femur in hysterectomised women when compared to women with intact uteri of same age group. 4 Moreover, hysterectomy along with bilateral oophorectomy leads to even earlier occurrence of osteoporosis as ovarian conservation in postmenopausal women has been shown to reduce the rate of bone loss due to the small amounts of estrogen produced from ovaries. 5 Fragility fracture is the most serious manifestation of osteoporosis, defined as a fracture occurring spontaneously or following minor trauma.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of osteoporosis in hysterectomised as compared to non-hysterectomized women in 7th decade of life

Shamim

Lal

Shamim³

2018

Int J Reprod Contracept Obstet Gynecol

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Background: Osteoporosis is considered as a major public health issue with fragility fractures of the hip, vertebrae and distal radius being the most important consequences. It has been said to be an age-related degenerative process. However, postmenopausal women develop this disease due to age-related bone mineral loss as well as due to declining levels of estrogen in the body following menopause leading to increased risk of fractures. Objectives of this study were to find out the prevalence of osteoporosis in hysterectomised and non-hysterectomised postmenopausal women in 7th decade of life.Methods: Descriptive cross-sectional study done on a total of 66 postmenopausal women who were in their 7th decade of life. They were divided into two groups, one consisting of 36 women who underwent natural menopause and the other group of 30 women who had surgical menopause. The bone mineral density of both the groups was measured using DEXA scan and comparison was done between these study groups.Results: Out of 30 hysterectomised subjects, 24 (80%) were found to be having osteoporosis, 6 (20%) had osteopenia and none had normal BMD. While out of 36 subjects in the non-hysterectomised group, 14 (38.88%) had osteoporosis, 16 (44.44%) had osteopenia and 6 (16.66%) subjects had normal BMD. Significant relation (p-value 0.001) was found on comparison of the study groups. In addition, significant positive correlation was between BMD and BMI whereas negative correlation was seen between BMD and parity.Conclusions: Hysterectomy was found to increase the incidence of osteoporosis. Obesity was found to have protective effect against bone mineral loss while increasing parity had a negative relation with BMD.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Prevalence of osteoporosis in hysterectomised as compared to non-hysterectomized women in 7th decade of life

Shamim

Lal

Shamim³

2018

Int J Reprod Contracept Obstet Gynecol

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“…With a few exceptions (23)(24)(25), however, most studies have found no excessive bone loss following hysterectomy alone (26)(27)(28)(29)(30)(31)(32)(33)(34). Moreover, if premature sex steroid deficiency were the predominant mechanism, one would expect fracture risk to increase with younger age at surgery (35).…”

Section: Discussionmentioning

confidence: 99%

Influence of hysterectomy on long-term fracture risk

Melton

Achenbach

Gebhart

et al. 2007

Fertility and Sterility

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Objective-To assess long-term fracture risk following hysterectomy, with or without oophorectomy.Design-Population-based cohort study. Setting-Olmsted County, Minnesota. Patients-9258Olmsted County women who underwent hysterectomy in 1965-2002 compared to an equal number of age-and sex-matched community controls.Interventions-Observational study of the effect of hysterectomy for various indications on subsequent fractures.Main outcome measures-Fractures of any type, and at osteoporotic sites (e.g., hip, spine, and wrist) alone, as assessed by electronic review of inpatient and outpatient diagnoses in the community.Results-Compared to controls, there was a significant increase (hazard ratio [HR], 1.21; 95% CI, 1.13-1.29) in overall fracture risk among the women with hysterectomy, but osteoporotic fracture risk was not elevated (HR, 1.09; 95% CI, 0.98-1.22). Most hysterectomy indications were associated with fractures generally, albeit often not statistically significantly, but only operations for uterine prolapse were associated with osteoporotic fractures (HR, 1.33; 95% CI, 1.01-1.74). Oophorectomy was not an independent predictor of fracture risk (HR, 1.0; 95% CI, 0.98-1.15).Conclusions-Hysterectomy does not appear to pose much long-term risk for fractures, but the association of fractures with surgery for uterine prolapse deserves further attention.

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“…Reduced (3)(4)(5), increased (6,7) and unchanged bone mineral density were seen in the studies (8)(9)(10). The increased bone resorption markers after the bilateral hysterectomy and oophorectomy revealed by Fiore CE and et al (11) showed that there was no negative effect of ovaries protective hysterectomy on osteoporosis.…”

Section: Introductionmentioning

confidence: 77%

Relationship of Bone Densitometry and Bone Resorption Markers With Menopausal Type and Duration

et al. 2010

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Objective: Menopause age and bone mineral density are positively related and there is a rapid bone loss in the early postmenopausal period. A ratio of 30% of post-menopausal women are affected from osteoporosis developing due to bone loss and this causes 40% risk of fracture in a 50-year old woman. Materials and Methods: In this sudy, serum osteocalcin and urine deoxypridinoline levels were analyzed in 102 postmenapausal and 48 healthy premenopausal controls who presented to gynecology outpatient clinic. Bone densitometry was obtained from all postmenopausal women. Postmenopausal patients were further divided into four groups according to time since menopause: <5 years, 5-9 years, 10-19 years and >20 years. Results: Mean (SD) age in 48 premenopausal women was 47.7 (3.7) while it was 56.5 (6.8) in 102 post-menopausal women. 34 out of 102 post-menopausal women had surgical menopause due to bilateral oopheroctomy+hysterectomy while the remaining had natural menopause. No significant difference was found in bone-turnover markers between women with surgical and natural menopause. Conclusion: Although there was not a statistically significant difference between bone-turnover markers, bone mineral density stays lower in surgical menopausal patients and this difference disappear only after about 20 years. Also bone turnover markers are usually high up to five years after surgical menopause and return to normal levels after then. Thus, our study suggested that oopheroctomy does not cause additional risk to hysterectomy. We also suggest that there is not a longterm relationship between serum bone turnover markers or bone density and the etiology of menopause. (Turk J Rheumatol 2010; 25: 29-33

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Effects of simple hysterectomy on bone loss

Cited by 20 publications

References 9 publications

Prevalence of osteoporosis in hysterectomised as compared to non-hysterectomized women in 7th decade of life

Prevalence of osteoporosis in hysterectomised as compared to non-hysterectomized women in 7th decade of life

Influence of hysterectomy on long-term fracture risk

Relationship of Bone Densitometry and Bone Resorption Markers With Menopausal Type and Duration

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