[Bilateral oophorectomy before menopause. Late effects on quality of life, lipid metabolism and bone mass.].

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 find 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 participants 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 performed. 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 controls were identified. Fifty women agreed to participate, 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 significant 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 deficiency than age-matched women who had undergone hysterectomy with preservation of the ovaries. A relatively long duration of estrogen use may be the main reason for this outcome.