Bilateral Oophorectomy May Have an Unfavorable Effect on Glucose Metabolism Compared With Natural Menopause

Abstract

The incidence of diabetes mellitus is rising worldwide. The aim of this prospective epidemiological study was to compare the effects of natural and surgical menopause on parameters of glucose metabolism. In a group of 587 repeatedly examined women, with a baseline age of 45-55 years, the following subgroups of women were separated: those after bilateral oophorectomy (BO, n=37) and those in natural menopause (NAT, n=380) including women menopausal already at baseline (POST, n=89). The study parameters including glycemia, insulinemia, HOMA-IR and beta-cell function using HOMA-β were determined at baseline and 6 years later. Over the study period, there was a marked rise in prediabetic and diabetic values of fasting glycemia; the percentage of women with diabetic values increased in the NAT (from 0.8 % to 3.9 %) and POST (from 2.2 % to 9.0 %) subgroups, with the highest prevalence in the BO subgroup (from 8.1 % to 10.8 %). While, among women with non-diabetic fasting glycemia, an increase in fasting glycemia was observed in all study subgroups, it was more marked in the BO subgroup than in the NAT and POST ones (p=0.02 both). This difference between NAT and BO was also found in the long-term trend of development of glycemia in non-diabetic women (p=0.014). Compared with natural menopause, bilateral oophorectomy may have an adverse effect on glucose metabolism.

Risk of Diabetes After Hysterectomy With or Without Oophorectomy in Postmenopausal Women

“…bilateral oophorectomy overall or a reduced risk associated with bilateral oophorectomy in a subgroup compared with premenopausal women. Two studies (21,22) observed an increased risk of diabetes in women who underwent hysterectomy concomitant with BSO, which is in line with our finding. However, Lejsková et al (22) did not examine the association between hysterectomy alone and risk of diabetes, and Appiah et al (21) observed a nonsignificantly increased risk of diabetes associated with hysterectomy alone (HR = 1.38, 95% CI: 0.94, 2.04).…”

“…Two studies (21,22) observed an increased risk of diabetes in women who underwent hysterectomy concomitant with BSO, which is in line with our finding. However, Lejsková et al (22) did not examine the association between hysterectomy alone and risk of diabetes, and Appiah et al (21) observed a nonsignificantly increased risk of diabetes associated with hysterectomy alone (HR = 1.38, 95% CI: 0.94, 2.04). In fact, the magnitude of the association found by Appiah et al is greater than our adjusted point estimate of 1.15 (95% CI: 1.07, 1.24) for hysterectomy only.…”

“…Appiah et al (21), using data from 2,597 postmenopausal women enrolled in the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study, reported that hysterectomy with BSO was significantly associated with diabetes risk (hazard ratio (HR) = 1.57, 95% confidence interval (CI): 1.03, 2.41), while hysterectomy alone was associated with a nonsignificantly increased risk of diabetes (HR = 1.38, 95% CI: 0.94, 2.04). In another small, prospective study (only 33 women with BSO), Lejsková et al (22) found that women with BSO had a significant increase in fasting glycemia compared with women with natural menopause. In a third study, a secondary analysis of a randomized controlled trial among glucose intolerant adults, Kim et al (23) reported no association between diabetes risk and bilateral oophorectomy.…”

Menopoz Tipi ve Süresinin Postmenopozal Kadınlarda Pre-Diyabet ve Diyabet Gelişimine Etkisi

“…Unlike natural menopause when falls in E2 occur within a few years, in surgical menopause created by bilateral oophorectomy, E2 ovarian production is cut rapidly and the reproductive life is suddenly terminated. Two previous studies have shown that there is a greater risk of DM in women with surgical menopause (22,23).…”

Changes in insulin resistance, glucose effectiveness, and first and second phases of insulin secretion in women aged 45–60 years old in Taiwan

“…The aforementioned studies unanimously indicated a significantly higher risk of developing diabetes in surgically induced menopausal women. [10][11][12][13] The potential mechanisms linking menopause and diabetes include increased adiposity and changes in sex hormones. [14][15][16][17] The most commonly investigated underlying pathophysiologies of T2D are insulin resistance (IR) and impaired insulin secretion.…”