Prevalence of osteoporosis in hysterectomised as compared to non-hysterectomized women in 7th decade of life
Keywords:BMD, DEXA, Hysterectomy, Osteoporosis, Postmenopausal
Background: Osteoporosis is considered as a major public health issue with fragility fractures of the hip, vertebrae and distal radius being the most important consequences. It has been said to be an age-related degenerative process. However, postmenopausal women develop this disease due to age-related bone mineral loss as well as due to declining levels of estrogen in the body following menopause leading to increased risk of fractures. Objectives of this study were to find out the prevalence of osteoporosis in hysterectomised and non-hysterectomised postmenopausal women in 7th decade of life.
Methods: Descriptive cross-sectional study done on a total of 66 postmenopausal women who were in their 7th decade of life. They were divided into two groups, one consisting of 36 women who underwent natural menopause and the other group of 30 women who had surgical menopause. The bone mineral density of both the groups was measured using DEXA scan and comparison was done between these study groups.
Results: Out of 30 hysterectomised subjects, 24 (80%) were found to be having osteoporosis, 6 (20%) had osteopenia and none had normal BMD. While out of 36 subjects in the non-hysterectomised group, 14 (38.88%) had osteoporosis, 16 (44.44%) had osteopenia and 6 (16.66%) subjects had normal BMD. Significant relation (p-value 0.001) was found on comparison of the study groups. In addition, significant positive correlation was between BMD and BMI whereas negative correlation was seen between BMD and parity.
Conclusions: Hysterectomy was found to increase the incidence of osteoporosis. Obesity was found to have protective effect against bone mineral loss while increasing parity had a negative relation with BMD.
Papaionnou A, Morin S, Cheung A, Atkinson S, Brown J, Jamal S. Clinical practice guidelines for the diagnosis and management of osteoporosis in Canada. Background and Technical Report. 2010:1-89.
National Institutes of Health Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy. Osteoporosis prevention, diagnosis, and therapy. JAMA. 2001;285:785-95.
Charles H. Approach to elderly patient with osteopenia and osteoporosis. In: Textbook of Internal Medicine. William N (ed), Philadelphia, Lippincot-Raven Publishers; 1997:2503-4.
Simoes R et al. Effects of simple hysterectomy on bone loss. J Sao Paulo Medical. 1995;113(6):1012-6.
Erekson E, Martin D, Ratner E. Oophorectomy: the debate between ovarian conservation and elective oophorectomy. Menopause. 2013;20(1):110-4.
Indumati V, Vidya SP, Rama J. Hospital based preliminary study on osteoporosis in postmenopausal women. Indian J Clin Biochem. 2007;22:96-100.
Nanjan R, Huda N. Assessment of osteoporosis in post-menopausal women: a clinical study. New J Obstet Gynaecol. 2011;6(2):11-3.
Meeyaong M, Botkin W. The association between osteoporosis and early menopause following hysterectomy. Los Angeles: Walden University Scholar Works; 2016.
Sharma S, Tandon V, Mahajan A, Kour A, Kumar D. Prelimnary screening of osteoporosis and osteopenia in urban women from Jammu using calcaneal Qus. J Indian Med Sci. 2006;60:185-9.
Singh T, Singh S, Sharma R, Kapila R. Prevalence and analysis of risk factors of osteoporosis in persons of above 40 years age group in Amritsar: a study of 500 cases. J Med Thesis. 2013;1(1):23-8.
Siddle N, Sarrel P, Whitehead M. The effect of hysterectomy on the age at ovarian failure: identification of a subgroup of women with premature loss of ovarian function and literature review. Fertil Steril. 1987;47:94-100.
Kritz-Silverstein D, von Mühlen DG, Barrett-Connor E. Hysterectomy and oophorectomy are unrelated to bone loss in older women. Maturitas. 2004;47:61-9.
Kritz-Silverstein D, Mühlen DGV, Barrett-Connor E. Hysterectomy and oophorectomy are unrelated to bone loss in older women. Maturitas. 2004;47(1):61-9.
Lohana CK, Samir N. Risk management of osteoporosis in post-menopausal women: a study of women in a teaching hospital. Glob J Health Sci. 2016;8(11):31-7.
Gopinath VR, Johnson P, Kumar AP, Pratibha M, Subhashini AS, Menon G. Prevalence of osteoporosis and evaluation of its risk factors in surgical and natural postmenopausal women: a pilot study. Sri Ramachandra J Med. 2010;3(1):9-13.
Klauss SV. Bone loss in premenopausal women: results of a prospective observational study over 9 years. Climacteric. 2002;15(5):433-40.
Simoes R. Effects of simple hysterectomy on bone loss. J Sao Paulo Med. 1995;113(6):1012-6.
Cheng S, Sievänen H, Heinonen A, Uusi-Rasi K, Carbone L, Tylavsky F, et al. Does hysterectomy with ovarian conservation affect bone metabolism and density? J Bone Mineral Metabol. 2003;21(1):12-6.
Cavkaytar S, Seval MM, Atak Z, Findik RB, Ture S, Kokanali D. Effect of reproductive history, lactation, first pregnancy age and dietary habits on bone mineral density in natural postmenopausal women. Aging Clin Exp Res. 2015;27(5):689-94.
Heidari B, Hosseini R, Javadian Y, Bijani A, Sateri MH, Nouroddini HG. Factors affecting bone mineral density in postmenopausal women. Arch Osteoporos. 2015;10:15.