Is There any Difference of Climacteric Symptoms between Natural and Surgical Menopause?

Abstract

Objective: To compare the effects of the natural and the surgical menopause (SM) on climacteric condition. Materials and methods: This prospective study was conducted from Jan 2008 to Jan 2013 in ZHSWMCH. Initially, 4,000 women were enrolled but finally 1,743 of natural menopause (NM) and 554 of SM were analyzed. All women were aged between 45 and 50 years, and they were of menopause for 1 to 5 years. Ethical and patient's permission was taken. Once enrolled, they were asked questions. The questions were related to menopausal symptoms (MS). Data was collected and analyzed by SPSS software. Results: Hot flushes, (535 vs 290, p < 0.001), sweating (344 vs 122, p < 0.001), poor memory (99 vs 65 p < 0.001), feeling depressed (335 vs 126, p < 0.001), dry skin/mucosa (229 vs 91, p < 0.001), decreased libido (289 vs 117, p < 0.001), dry vagina (99 vs 65, p < 0.001) and urinary complains (59 vs 42, p < 0.001) were found in SM vs NM. Hypertension or cardiovascular disease was more (191 vs 92, p < 0.01), blood sugar were more (90 vs 32, p < 0.001) and metabolic syndrome are also more (48 vs 26, p < 0.07) in SM than NM but this did not reach the significance. Conclusion: Menopausal symptoms are common in both NM and SM. These MS were significantly higher in surgically menopause women and they were troubled more, so we need to be cautious about oophorectomy, and ovarian preservation should be the aim in all benign cases. Of course, we need to assess the risks and benefit where there is risk of ovarian cancer during the time of total abdominal hysterectomy. Both hormone replacement therapy (HRT) (following a risk/benefit analysis) and treatment of osteoporosis may be recommended after surgery to decrease the climacteric symptoms and osteoporosis in women with menopausal symptoms.