Please wait a minute...
Clinical and Experimental Obstetrics & Gynecology  2020, Vol. 47 Issue (2): 179-182    DOI: 10.31083/j.ceog.2020.02.5037
Original Research Previous articles | Next articles
The impact of surgical menopause on metabolic syndrome, bone mineral density, and vasomotor symptoms
F. N. Tuysuzoglu1, *(), G. A. Ilhan1, B. Yildizhan1
1Marmara University School of Medicine, Department of Obstetrics and Gynecology, Istanbul, Turkey
Download:  PDF(1310KB)  ( 275 ) Full text   ( 11 )
Export:  BibTeX | EndNote (RIS)      

Purpose: The aim of this study is to compare the effects of surgical and natural menopause on vasomotor symptoms, osteoporosis, and metabolic syndrome. Materials and Methods: Seventy menopausal women fulfilling the inclusion criteria were divided into two groups according to surgical and natural menopause. Metabolic syndrome (MS) was defined according to the International Diabetes Federation. Vasomotor symptoms were scored according to the presence of hot flashes and night sweats. The participants had a bone mineral density (BMD) evaluation of the total lumbar spine and total hip bone. Results: The rates of vasomotor symptoms were similar among groups (p > 0.05). MS was significantly higher in surgical menopause group than in natural menopause group (p < 0.05). Women with surgical menopause were found to be more osteopenic at level L1-L4 (p < 0.05). Furthermore there were no differences between the femoral neck, femora total T scores, and BMDs of two groups. Conclusion: Compared with natural menopause, surgical menopause was found to be associated with higher rates of MS and osteoporosis but not with vasomotor symptoms.

Key words:  Surgical and natural menopause      Vasomotor symptoms      Bone mineral density      Metabolic syndrome     
Published:  15 April 2020     
*Corresponding Author(s):  F. N. Tuysuzoglu     E-mail:

Cite this article: 

F. N. Tuysuzoglu, G. A. Ilhan, B. Yildizhan. The impact of surgical menopause on metabolic syndrome, bone mineral density, and vasomotor symptoms. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(2): 179-182.

URL:     OR

Table 1  — Clinical, hormonal, metabolic characteristics, and bone mineral density of groups.
Variable Surgical menopause (n=35) Natural menopause (n=35) p
Age (years) 50.05±2.74 50.62±3.78 0.472
Gravidity 2.9±2.06 3.11±2.09 0.689
Parity 2.57±1.44 2.57±1.61 1.00
Abortions 0.34±1.16 0.54±1.01 0.445
BMI (kg/m2) 31.24±4.87 30.00±5.2 0.309
BUN (mg/dl) 14.05±3.09 12.79±2.91 0.083
Cr (mg/dl) 0.68±0.11 0.67±0.09 0.741
AST(U/L) 23.91±10.24 21.54±4.56 0.215
ALT(U/L) 23.28±6.86 20.82±6.97 0.142
Menopause duration (months) 30.28±12.53 34.14±15.25 0.252
Vasomotor symptom 22(%62, 85) 20(%57, 14) 0.626
Metabolic syndrome 14(%40) 6(%17, 14) 0.034*
HOMA-IR 3.19±2.73 2.64±0.18 0.359
Systolic blood pressure (mmHg) 133.28±15.00 121.14±13.57 0.001**
Diastolic blood pressure (mmHg) 80.62±9.80 70.08±10.26 <0.001**
HDL cholesterol (mg/dl) 54.00±10.04 61.54±13.79 0.011*
LDL cholesterol (mg/dl) 134.86±31.72 143.28±28.95 0.251
Total cholesterol (mg/dl) 213.85±37.28 229.77±38.33 0.083
Triglycerides (mg/dl) 125.57±2.19 124.14±58.25 0.914
L1-L4 T score -1.01±1.35 -0.43±1.04 0.048*
L1-L4 BMD (gr/cm2) 1.025±0.16 1.09±0.12 0.045*
Femoral neck T score -0.40±1.02 -0.11±0.80 0.185
Femoral neck BMD (gr/cm2) 0.90±0.11 0.93±0.09 0.186
Femora total T score 0.17±1.04 0.17±0.93 0.510
Femoral total BMD (gr/cm2) 0.97±0.12 0.99±0.11 0.451
[1] Davison S., Bell R., Donath S., Montalto J., Davis S.R.: “Androgen levels in adult females: changes with age, menopause and oophorectomy”. J. Clin. Endocrinol. Metab., 2005, 90, 3847.
doi: 10.1210/jc.2005-0212 pmid: 15827095
[2] Langren B.M., Collins A., Csemiczky G., Burger H.G., Baksheev L., Robertson D.M.: “Menopause transition: annual changes in serum hormonal patterns over the menstrual cycle in women during a nine-year period prior to menopause”. J. Clin. Endocrinol. Metab., 2004, 89, 2763.
doi: 10.1210/jc.2003-030824 pmid: 15181055
[3] Grundy S.M., Brewer Jr. H.B., Cleeman J.I., Smith Jr. S.C., Lenfant C. : “Definition ofmetabolic syndrome: report of the National Heart, Lung, and Blood Institute/American Heart Association Conference on Scientific Issues Related to Definition”. Arterioscler. Thromb. Vasc. Biol., 2004, 24, e13.
doi: 10.1161/01.ATV.0000111245.75752.C6 pmid: 14766739
[4] Lindsay R. : “Sex steroids in the pathogenesis and prevention ofosteoporosis”.. In: Riggs B.L., Melton L.J, (eds). Osteoporosis: etiology, diagnosis, and management. New York, Raven Press, 1988, 333.
[5] Alberti K.G, Zimmet P., Shaw J.: “The metabolic syndrome: a new worldwide definition”. Lancet, 2005, 366, 1059.
doi: 10.1016/S0140-6736(05)67402-8 pmid: 16182882
[6] Matthews D.R., Hosker J.P., Rudenski A.S., Naylor B.A., Treacher D.F., Turner R.C.: “Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man”. Diabetologia, 1985, 28, 412.
doi: 10.1007/BF00280883 pmid: 3899825
[7] WHO study group.: “Assesment of Fracture Risk and Its Application to Screening for Postmenopausal Osteoporosis”. In: WHO Technical Report Series, Geneva, Switzerland: 1994, 1.
[8] Parker W.H., Broder M.S., Liu Z., Shoupe D., Farquhar C., Berek J.S.: “Ovarian conservation at the time of hysterectomy for benign disease”. Clin. Obstet. Gynecol., 2007, 50, 354.
doi: 10.1097/GRF.0b013e31804a838d pmid: 17513923
[9] Farahmand M., Ramezani Tehrani F., Bahri Khomami M., Noroozzadeh M., Azizi F.: “Surgical menopause versus natural menopause and cardio-metabolic disturbances: a 12-year population-based cohort study”. J. Endocrinol. Invest., 2015, 38, 761.
doi: 10.1007/s40618-015-0253-3 pmid: 25722224
[10] Hidalgo L.A., Chedraui P.A., Morocho N., Alvarado M., Chavez D., Huc A.: “The metabolic syndrome among postmenopausal women in Ecuador”. Gynecol Endocrinol., 2006, 22, 447.
doi: 10.1080/09513590600890272 pmid: 17012107
[11] Gierch G.L., Johnson B.D., Merz N.B., Kelsey S.F., Bittner V., Olson M.B. et al.: “Hypertension, menopause, and coronary artery disease risk in the Women’s Ischemia Syndrome Evaluation (WISE) study”. J Am Coll Cardiol., 2006, 47, 50.
[12] Dørum A.1., Tonstad S., Liavaag A.H., Michelsen T.M., Hildrum B., Dahl A.A.: “Bilateral oophorectomy before 50 years of age is significantly associated with the metabolic syndrome and Framingham risk score: a controlled, population-based study (HUNT-2)”. Gynecol. Oncol., 2008, 109, 377.
doi: 10.1016/j.ygyno.2008.02.025 pmid: 18407340
[13] Rexrode K.M., Carey V.J., Hennekens C.H., Walters E.E., Colditz G.A., Stampfer M.J., et al.: “Abdominal adiposity and coronary heart disease in women“. JAMA, 1998, 280, 1843.
doi: 10.1001/jama.280.21.1843 pmid: 9846779
[14] Schubert C.M., Rogers N.L., Remsberg K.E., Sun S.S., Chumlea W.C., Demerath E.W., et al.: “Lipids, lipoproteins, lifestyle, adiposity and fat-free mass during middle age: the Fels Longitudinal Study”. Int. J. Obes. (Lond.), 2006, 30, 251.
doi: 10.1038/sj.ijo.0803129
[15] Carr M.C.: “The emergence of the metabolic syndrome with menopause”. J. Clin. Endocrinol. Metab., 2003, 88, 2404.
doi: 10.1210/jc.2003-030242 pmid: 12788835
[16] Middelberg R.P., Spector T.D., Swaminathan R., Snieder H.: “Genetic and environmental influences on lipids, lipoproteins, and apolipoproteins: effects of menopause” Arterioscler. Thromb. Vasc. Biol., 2002, 22, 1142.
doi: 10.1161/01.atv.0000022889.85440.79 pmid: 12117729
[17] Cho G.J., Lee J.H., Park H.T., Shin J.H., Hong S.C., Kim T., et al.: “Postmenopausal status according to years since menopause as an independent risk factor for the metabolic syndrome. ” Menopause, 2008, 15, 524.
[18] Pansini F., Bagni B., Bonaccorsi G.: “Oophorectomy and Spine Bone Density: Evidence of a Higher Rate of Bone Loss in Surgical Compared with Spontaneous Menopause”. Menopause, 1995, 2, 109
[19] Ohta H., Makita K., Suda Y., Ikeda T., Masuzawa T., Nozawa S.: “Influence of oophorectomy on serum levels of sex steroids and bone metabolism and assessment of bone mineral density in lumbar trabecular bone by QCT-C value”. J. Bone Miner Res., 1992, 7, 659.
doi: 10.1002/jbmr.5650070610
[20] Schwingl P.J., Hulka B.S., Harlow S.D.: “Risk factors for menopausal hot flashes”. Obstet. Gynecol., 1994, 84, 29.
pmid: 8008318
[21] Sierra B., Hidalgo L.A., Chedraui P.A.: “Measuring climacteric symptoms in an Ecuadorian population with the Greene Climacteric Scale” Maturitas., 2005, 51, 236.
doi: 10.1016/j.maturitas.2004.08.003 pmid: 15978967
[1] R. Tachibana, H. Matsushita, A. Minami, N. Morita, S. Shimizu, H. Kanazawa, T. Suzuki, K. Watanabe, A. Wakatsuki. Dietary sesame diminishes bone mass and bone formation indices in ovariectomized rats[J]. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(4): 546-551.
[2] N. Morita, H. Matsushita, A. Minami, S. Shimizu, R. Tachibana, H. Kanazawa, T. Suzuki, K. Watanabe, A. Wakatsuki. Effect of the methanol extract of the Lion’s Mane mushroom, Hericium erinaceus, on bone metabolism in ovariectomized rats[J]. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(1): 47-52.
[3] H.M.G. Youssef, E.S. Marei, L.A. Rashed. Long non-coding RNA steroid receptor activator in polycystic ovary syndrome: possible association with metabolic syndrome[J]. Clinical and Experimental Obstetrics & Gynecology, 2019, 46(5): 757-762.
[4] M. Trisovic, O. Mladenovic, J. Bila, K. Lalić, D. Kisic Tepavcevic. The predictive value of metabolic syndrome in the evaluation of pregnancy course and outcome[J]. Clinical and Experimental Obstetrics & Gynecology, 2019, 46(5): 776-778.
[5] H.A. Mansouri. Do bone turnover markers change with a steep drop in maternal steroids?[J]. Clinical and Experimental Obstetrics & Gynecology, 2019, 46(5): 784-786.
[6] Jung Yeob Seoung, Suk Woo Lee, Young Mo Kang, Min Jung Kim, Jae Min Park, Hye Min Moon, Chae Chun Rhim. Association between metabolic risks and bone mineral density in postmenopausal women[J]. Clinical and Experimental Obstetrics & Gynecology, 2018, 45(5): 671-676.
[7] Y.J. Lee, K.Y. Yun, S.C. Kim, J.K. Joo, K.S. Lee. The association between cystatin C and metabolic syndrome according to menopausal status in healthy Korean women[J]. Clinical and Experimental Obstetrics & Gynecology, 2017, 44(5): 716-720.
[8] L. H. Sordia-Hernández, P. Ancer Rodríguez, D. Saldivar Rodriguez, S. Trejo Guzmán, E. S. Servín Zenteno, G. Guerrero González, R. Ibarra Patiño. Effect of a low glycemic diet in patients with polycystic ovary syndrome and anovulation - a randomized controlled trial[J]. Clinical and Experimental Obstetrics & Gynecology, 2016, 43(4): 555-559.
[9] N. Kurtoglu-Aksoy, S.E. Akhan, E. Bastu, F. Gungor-Ugurlucan, A. Telci, A.C. Iyibozkurt, S. Topuz. Implications of premature ovarian failure on bone turnover markers and bone mineral density[J]. Clinical and Experimental Obstetrics & Gynecology, 2014, 41(2): 149-153.
[10] P. De Franciscis, G. Mainini, D. Labriola, S. Leo, F. Santangelo, A. Luisi, C. Russo F.V. Cerreto, D. Ambrosio, M. Torella. Low-dose estrogen and drospirenone combination: effects on metabolism and endothelial function in postmenopausal women with metabolic syndrome[J]. Clinical and Experimental Obstetrics & Gynecology, 2013, 40(2): 233-235.
[11] J.H. Check, R. Cohen, D. Check. A novel highly effective therapy for severe vasomotor symptoms in an estrogen deficient woman – case report[J]. Clinical and Experimental Obstetrics & Gynecology, 2010, 37(3): 229-230.
[12] K. Ikeuchi, N. Umesaki. Factors affecting bone mineral density of young women and predictive factors of low bone mineral density[J]. Clinical and Experimental Obstetrics & Gynecology, 2009, 36(2): 87-90.
No Suggested Reading articles found!