Hypothesis / aims of study
Menopause resulting from the removal of both ovaries before natural menopause, either through hysterectomy or bilateral salpingo-oophorectomy (BSO), is defined as surgical menopause. While estrogen levels in the body decrease over time during natural menopause, there is no transition period to menopause in surgical menopause due to bilateral oophorectomy. Therefore, menopausal symptoms are more intense and severe in women undergoing surgical menopause compared to women undergoing natural menopause. A literature review revealed that studies addressing both natural and surgical menopause together, or only natural menopause in terms of depression, anxiety, menopausal symptoms, sexuality, or level of knowledge and attitudes, were conducted (1-3). Research addressing surgical menopause is limited.
This study was conducted to identify menopausal symptoms arising from surgical menopause in women of reproductive age and to examine the effect of surgical menopause on sexual function.
Study design, materials and methods
This descriptive and correlation seeking study was conducted with 43 women who had hysterectomy and/or bilateral
salpingooophorectomy surgery at the Training and Research Hospital affiliated with the Ministry of Health between 01.11.2023 and 01.05.2024. Research data were collected using the "Introductory Information Form", "Menopause Symptom Assessment Scale (MSDS)", "Female Sexual Function Index (FSFI)", at least two weeks before surgery and 6-8 days after surgery. It was collected through face-to-face meetings over weeks. The data were analyzed in a statistical package program.
Inclusion Criteria;
-Women who have undergone hysterectomy and/or bilateral salpingo-oophorectomy surgery
-Women who have signed consent to participate in the study
-Sexually active women
-Women who have had at least one menstruation in the last 12 months
Exclusion Criteria;
-Women with language and communication problems
-Women who have received chemotherapy and/or radiotherapy treatment prior to surgery
-Women with diagnosed psychiatric illness
Results
The average age of the women who underwent surgery was 45.510±2.694 years (Min=40; Max=49), their education level was mostly primary school (32.6%) and below, most were married (88.4%), and their income level was middle (72.1%), 44.2% of the women included in the study were smokers or alcohol consumers, 41.9% had a history of chronic diseases,
In obstetric history, the average number of pregnancies was more than 3, the average number of births was more than 2,
51.2% did not experience miscarriage or curettage, 44.2% had a history of previous gynecological surgery.
The MSDS total average score was 9,861±4,357, and the women participating in the study experienced low-level symptoms and had the most psychological and the least somatic complaints.
The mean FSFI score of menopausal women before surgery was 25.570±8.814 and the mean FSFI score after surgery was 20.277±8.258, and a significant decrease was observed after surgery (p<0.05). The post-operative total and there is a negative relationship between sub-dimension scores and the total MSDS score and its sub-dimensions.
Interpretation of results
This study indicates that changes in menopausal symptoms and sexual function in women undergoing surgical menopause are not significantly influenced by sociodemographic factors such as age, education level, or prior gynecological surgery. However, the presence of chronic illness was associated with a decrease in menopausal symptom scores, suggesting a potential moderating effect. In addition, a negative correlation was found between menopausal symptom severity and sexual function scores, indicating that increased menopausal complaints are associated with poorer sexual functioning. Furthermore, a statistically significant decrease was observed in the FSFI total score and its subscale scores after surgery compared to pre-surgery (p<0.05).