Surgical Menopause: Are we Pushing Women Towards the Menace of Accelerated Aging and Diseases?
Description
It is a routine practice among gynecologists and general practitioners to recommend hysterectomies for benign
gynecological diseases. This article is challenging this practice. I) Natural menopause: The reproductive life is divided into
5 stages showing the transition of reproductive function. Discussed the stages of normal reproductive aging in women based
on (STRAW +10) 2014.The average age of Menopause is 51 years. Menopausal transitional symptoms occur few years
before final natural menopause as changes in the pattern of menstrual cycle, vasomotor hot flushes, night sweats, sleep
disturbances, psychological and mental disturbances, somatic symptoms headache, dizziness, palpitations ii) Surgical
Menopause: Surgical menopause causes severe symptoms due to the sudden fall of estrogen, progesterone, and ovarian
androgen. Though ovarian failure develops in 2-5 years after surgery hormone deficiency occurs immediately and
symptoms can occur as early as 24-48 hrs. iii) Ovarian function after hysterectomy done at a pre-menopausal age: Most
likely causes of premature ovarian failure after Hysterectomy where ovaries are conserved a)Interference with ovarian
blood supply at the time of surgery. b) Disturbance of Endometrial ovarian relationship c) Deficiency of Uterine
Prostaglandins d) Loss of putative reflex pathway from the cervix to the pituitary. iv) The appearance of menopausal
symptoms. v) Difference between Natural Menopause and Surgical Menopause: Surgical menopause with bilateral
oophorectomy increases morbidity and is linked to accelerated aging. vi) Recommendation for AUB management for
benign gynecological disease: Therapeutic Indications of Hysterectomy can be narrowed down to a few life-threatening
indications of the ovary, uterus, and cervical malignancies. Prophylactic oophorectomy is done in high-risk BRCA -
positive patients.
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References
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