THE INFLUENCE OF PREMENOPAUSAL SIMPLE HYSTERECTOMY ON BONE MASS DENSITY

Objective To evaluate the effect of premenopausal hysterectomy on bone mass in women in their fifties Setting Governmental teaching hospital Study Design Prospective cross sectional study on 25 healthy women who had premenopausal hysterectomy before the age of 45 & at least 2 years before the study with 40 healthy natural post- menopausal women 45-60 years old. Evaluation of menopausal state was done by serum FSH & serum estradiol, bone mineral density (BMD) of the left proximal femur was determined by dual X-ray absorptiometry in six regions (femoral neck, greater trochanter, intertrochanteric area, wards triangle, shaft and total hip region). Evaluation of bone remodeling was done by measuring serum alkaline phosphatase. The results of both groups were compared. Results The study showed slight increment of BMD among cases with hysterectomy than the control group by an amount ranging between 1.9% in the femoral shaft to 4.8% in greater trochanter & wards triangle. These differences were not statistically significant, even when they were exceptionally significant as the case with BMD of the femoral neck & intertrochanteric areas, they were too small in magnitude to be of clinical relevance. Conclusion Hysterectomy had no impact on bone mineralization even after adjusting for duration of menopause