Effects of Simple Premenopausal Hysterectomy on Bone Mineral Density

Lee, C G; Kim, K S; Min, B G; Kim, H G; Lee, H S; Hong, G Y

Abstract

Hysterectomy is one of the most common gynecologic surgical intervention, although there are large variation in the frequency both among and within nation. The future function of ovaries retained after premenopausal hysterectomy has been questioned. Several studies have described increased severity of menopausal symptoms and earlier onset of menopause attributed to reduced ovarian estrogen production. Bone tissue is very sensitive to steroid hormones. Estrogen deprivation as seen at the menopause and after premenopausal oophorectomy causes rapid bone loss. Also, minor disturbances in ovulatory function can influence bone metabolism. A reduction in ovarian function after hysterectomy may therefore cause advanced bone loss and increase risk of subsequent osteoporotic fractures. The purpose of this study was to investigate whether premenopausal hysterectomy has an effect on bone mass in women. This study was performed on 50 women who had undergone premenopausal hysterectomy and 50 women with natural menopause 50 to 60 years old. Bone mineral densities in lumbar spine (L2-4), proximal femur, and total body were measured by dual energy x-ray absorptiometry. The women who had undergone premenopausal hysterectomy had generally lower mineral densities in all bone compartment compared with those with intact uterus, apart from 1.2% to 9.3% lower bone mineral densities. In conclusion, premenopausal hysterectomy did not influence bone metabolism significantly, but further study is necessary continuously.