Læknablaðið - 15.12.1999, Blaðsíða 35

LÆKNABLAÐIÐ 1999; 85
969
Brottnám eggjastokka
fyrir tíðahvörf
Áhrif á lífsgæði, fituefnaskipti og beinþéttni
Eva Sigvaldadóttir1, Jens A. Guðmundsson2, Gunnar Sigurðsson3, Matthías Kjeld4
Sigvaldadóttir E, Guðmundsson JA, Sigurðsson
G, Kjeld M
Bilateral oophorectomy before mcnopause. Late
effects on quaiity of life, lipid metabolism and
bone mass
Læknablaðið 1999; 85: 969-74
Objective: Oophorectomy in premenopausal women
may profoundly affect health. This study was done to
investigate whether it had influenced the quality of
life, lipid metabolism and bone mass if removal of
the ovaries in premenopausal women was performed
more than 15 years ago.
Material and methods: Operation records from the
Department of Obstetrics and Gynecology at the
National University Hospital, Reykjvík, were scruti-
nized to fínd all women who during 1977-1984 had a
bilateral oophorectomy performed at less than 47
years of age at the time of operation. A control group
of age-matched women, who during the same period
had undergone a hysterectomy with preservation of
the ovaries, was chosen. Women with malignant and
chronic disabling diseases were excluded. The parti-
cipants answered 36 standardized questions relating
to menopausal symptoms, hormonal use and smo-
king. Mesurements of total serum cholesterol, HDL
(high density lipoprotein) and LDL (low density
lipoprotein) cholesterol, triglycerides and calcium
and fasting urine calcium and creatinine, were per-
Frá 'læknadeild Háskóla Islands, 2Kvennadeild Landspít-
alans, 3lyflækningadeild Sjúkrahúss Reykjavíkur, “rann-
sóknastofu Landspítalans í blóðmeinafræði. Fyrirspurnir,
bréfaskipti: Jens A. Guðmundsson. Kvennadeild Land-
spítalans, 101 Reykjavík. Sími: 560 1000, bréfsími: 560
1191, netfang: jens@rsp.is
Lykilorð: brottnám eggjastokka, brottnám legs, tíðahvarfa-
einkenni, beinþéttni.
formed. Bone mineral density was assessed by dual
energy X-ray absorptiometry in the lumbar spine, left
hip and femoral neck.
Results: Thirty-four patients and equally many con-
trols were identified. Fifty women agreed to partici-
pate, but two did not attend for the investigation,
giving a total of 26 cases and 22 controls. Mean age
at the time of operation was 43.3 years for cases and
43.5 and controls. The difference in the duration of
hormone use (11.6 and 8.9 years) was not significant.
Of the 36 questions on climacteric symptoms there
was a signifícant difference between the groups in
only one. Cases and controls were not different with
regard to serum lipids and bone mineral density.
Mean values of bone mineral density in both groups
were within the normal limits for an age-matched
general population.
Conclusions: Women who underwent removal of the
ovaries before 47 years of age, more than 15 years
later, were not shown to have suffered more from
longterm effects of estrogen defíciency than age-
matched women who had undergone hysterectomy
with preservation of the ovaries. A relatively long du-
ration of estrogen use may be the main reason for this
outcome.
Keywords: oophorectomy, hysterectomy, climacteric
symptoms, bone mass.
Ágrip
Markmið: Brottnám eggjastokka í konum,
sem ekki hafa náð tíðahvörfum, getur haft nei-
kvæð áhrif á heilsu þeirra. Tilgangur þessarar
rannsóknar var að kanna hvort það hefði haft
áhrif á lífsgæði, fituefnaskipti og beinþéttni, ef
eggjastokkar voru fjarlægðir hjá konum fyrir
tíðahvörf og fyrir meira en 15 árum.
Efniviður og aðferðir: Kannaðar voru að-
gerðabækur á Kvennadeild Landspítalans frá
árunum 1977-1984 og fundnar allar aðgerðir
þar sem eggjastokkar höfðu verið fjarlægðir
hjá konum sem voru yngri en 47 ára. Til sam-