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Oophorectomy and Spine Bone Density

1995; Lippincott Williams & Wilkins; Volume: 2; Issue: 2 Linguagem: Inglês

10.1097/00042192-199502020-00008

1530-0374

F. Pansini, B Bagni, Gloria Bonaccorsi, Paola Albertazzi, Laura Zanotti, Antonio Farina, Carlo Pietro Campobasso, Roberto Orlandi, Gioacchino Mollica,

Endometriosis Research and Treatment

To compare the influence of spontaneous and surgical menopause on bone loss, we measured with dual x-ray absorptiometry (DXA) the spinal bone mineral density (BMD) in 513 women recruited at the Menopause Clinic at Ferrara University Hospital. One hundred one women were premenopausal with regular menstrual cycles; 185 women were perimenopausal with irregular periods or with absence of menstruation for <11 months; 160 women had spontaneous menopause with at least 12 months of amenorrhea; 67 women had a surgical menopause (hysterectomy with bilateral oophorectomy) prior to which they had regular menstruation. To minimize the age bias on BMD, all postmenopausal patients were selected to have the age range at menopause corresponding with the chronological age range (45–53 years) of premenopausal women used as reference. Moreover, to evaluate the influence of time since menopause on BMD, all postmenopausal women were stratified in five categories according to time lapsed since their last menses or oophorectomy. BMD values of spontaneous and surgical menopause do not appear to differ significantly (0.908 4pM 0.146 and 0.885 ± 0.129 g/cm2, mean ± SD). However, the difference between the menopausal groups becomes evident when BMD results take into account the interval since menopause. After 61–144 months of amenorrhea, women who had undergone spontaneous menopause had a cumulative bone loss of 21.8% in comparison with premenopausal BMD, whereas women who had undergone surgical menopause had a bone loss of 25.8%. The yearly percentage of bone loss values of surgical menopause (ranging from 3.72 to 7.93) settled to ∼1% per year after 5 years from oophorectomy, whereas the percentage values of spontaneous menopause (ranging from 1.75 to 4.65) settled to 1% per year after 3 years since the last menses. The difference between bone loss rates of spontaneous and surgical menopause, evaluated by comparison of regression coefficients (— 0.027 and —0.051, respectively) of linear regressions of BMD values on time since menopause, was statistically significant (p ≤ 0.001). Odds ratio (OR) of osteopenia (as Tscore, ≥ — 1) was significantly higher in surgical menopause (OR, 10.36; CI, 24.69–4.34) compared with spontaneous menopause (OR, 7.11; CI, 14.73–3.43). Our data support the evidence that women undergoing bilateral oophorectomy while still menstruating are at a higher risk of osteopenia than women undergoing menopause spontaneously.