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Adding oophorectomy to abdominal hysterectomy affects the vasomotor and sexual function and mental status of patients.

Hysterectomy is performed for multiple benign and malignant conditions. The ovaries may or may not be excised during the surgery. The choice of surgical approach depends on clinical findings, surgical expertise, and patient preference. Surgical menopause after total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH+BSO) results in sudden hormonal changes and severe menopausal symptoms. A study in the journal Medical Records has explored the effects of surgical menopause on vasomotor symptoms, sexual function, and mental status.

Patient Characteristics

This study included 106 women who underwent surgery in the perimenopausal period for benign indications, 51 of whom underwent total abdominal hysterectomy and bilateral salpingectomy (TAH+BS), and 55 who underwent TAH+BSO. The average age in the TAH+BS and TAH+BSO groups was approximately 43 and 50 years, respectively. All of the patients in the TAH+BSO group were multiparous, while 92.2% in the TAH+BS group were multiparous.

Higher Prevalence of Vasomotor Symptoms in TAH+BSO Group

Patients were questioned about vasomotor symptoms, including hot flashes and night sweats, after surgery. The proportion of patients with these symptoms was considerably higher in the TAH+BSO (70.9%) compared to the TAH+BS group (11.8%), (p < 0.001). The rapid hormonal change in surgical menopause with oophorectomy is thought to be the reason behind this.

Higher Incidence of Vaginal Dryness and Dyspareunia in TAH+BSO Group

The proportion of patients experiencing vaginal dryness and/or dyspareunia after surgery was higher in the TAH+BSO group. These symptoms were observed in 47.3% of the TAH+BSO group participants and 21.6% of the TAH+BS group participants (p = 0.005).

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Impact of TAH+BSO Surgery on Memory, Sleep, and Anxiety

Memory issues such as attention disorder and forgetfulness were found in 34.5% of TAH+BSO group patients and 7.8% of TAH+BS group patients (p = 0.009). Sleep disorders such as insomnia, fatigue, and sleepiness were reported by 34.5% of TAH+BSO and 7.8% of TAH+BS patients (p = 0.001). The mean post-op Beck Anxiety Inventory score was higher in the TAH+BSO group, with scores of 10 ± 6 and 8 ± 6 in the TAH+BSO and TAH+BS groups, respectively (p = 0.009). These scores were found to be correlated with postmenopausal symptoms in the TAH+BSO group.

In conclusion, vasomotor symptoms, vaginal dryness and/or dyspareunia, sleep disorders, memory problems, and anxiety levels were considerably higher in the TAH+BSO group compared to TAH+BS patients. More studies are needed to explore the balance of health benefits and risks of prophylactic bilateral oophorectomy.  

Source

Gölbaşi, C., Gölbaşi, H., Bayraktar, B., Uçar, E., Ömeroğlu, İ., Omeroglu, Ş. K., & Taner, C. E. (2022). The effect of surgical menopause on vasomotor symptoms and anxiety in women: A prospective study. Medical Records-international Medical Journal. https://doi.org/10.37990/medr.1160498