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The effect of surgical menopause on BMD and fracture incidence was found to be comparable with that of natural menopause.
Oophorectomy is the surgical procedure for removal of the ovaries. Surgery is indicated when women are at great risk of developing ovarian cancer. When the surgery is performed at premenopausal age, it produces acute surgical menopause, with undesired outcomes.
Recently, a group of investigators performed a systematic review and meta-analysis to examine the incidence of bone mineral density (BMD) and fracture after surgical menopause. A literature search was carried out on PubMed, EMBASE and Cochrane library without any date restriction. Primary studies describing BMD, T-scores or fracture incidence in women with surgical menopause and age-matched control groups were selected for inclusion.
Data on BMD (g/cm2), T-scores and fracture prevalence in women with surgical menopause and control groups were extracted. Assessment of quality was performed by an adaptation of the Downs and Black checklist. Random effects models were utilized to meta-analyse results of studies reporting on BMD or fracture incidence.
A total of 17 studies were incorporated comprising 43386 women with surgical menopause, out of which ten studies provided sufficient data for meta-analysis. BMD was found to be significantly lower after surgical menopause than in premenopausal age-matched women. But was not lower than in women with natural menopause. The incidence of hip fracture was not found to be higher after surgical menopause compared to natural menopause.
The studies did not reveal any apparent effects of surgical menopause on BMD and fracture prevalence as compared to natural menopause. Though, available studies are prone to bias and need to be understood with caution.
BJOG: An International Journal of Obstetrics and Gynaecology
Bone mineral density and fractures after surgical menopause: a systematic review and meta-analysis
Fakkert IE et al.
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