Manifestations of somatic disturbances in early postmenopause in women after physiological and surgical menopause

• Published in: Vojnosanitetski pregled Vol. 63; no. 11; pp. 929 - 932
• Main Authors: Nincic, Dejan, Zikic, Dragan, Ivkovic-Kapicl, Tatjana, Mastilovic, Katarina
• Format: Journal Article
• Language: English
• Published: Military Health Department, Ministry of Defance, Serbia 2006
• Subjects: hot flashes; menopause; postmenopause; psychophysiologic disorders; quality of life; women
• ISSN: 0042-8450; 2406-0720
• DOI: 10.2298/VSP0611929N

Background/Aim. The most common secondary manifestations of menopause are clinical manifestations of estrogen deficiency. They could be early and late. The aim of this study was to compare manifestations of somatic disturbances in early postmenopause in women after physiological and surgical menopause. Methods. This prospective study included 60 women, age 41-55 years, divided into two groups: physiological (30 of them) and surgically induced menopause. For every subject a special evidence list, consisting of the disease history questions, physical and gynecology examination as well as dates about physiological variables (arterial tension, height, weight, and body-mass index) and laboratory examination was formed. The values of arterial blood pressure, body height, body mass, body mass index (BMI), and lipid status were determined and gynecological examinations were performed in each patient. Results. The most frequent symptoms in both groups were vasomotor ones. Headache was the more intensive sign in the group after induced menopause. Extra systolic heart excursion was a common symptom in both study groups. Arterial tension, regardless of the type of menopause, was in the physiological range. The frequent organic signs of menopause, more intensive in the group after induced menopause, were genitourinary and skin atrophy. An analysis of the BMI showed that the women in both groups were obese (BMI > 25). The lipids analysis confirmed the predomination of hyperlipoproteinemia type IIa in the group with physiologic menopause and type IIb after induced menopause. Conclusion. The dominant signs of menopausal syndrome were vasomotor and bone-joint symptoms, more frequent in the group after induced menopause. There were no statistically significant differences between the study groups according to the genitourinary atrophy and other signs of aging. Menopausal hormonal changes, regardless of the way of menopause developing, increase the risk for hyperlipoproteinemia. The frequency of somatic signs in early post menopause is typically higher after induced menopause. More intensive follow-up in patients after surgical removing of the ovaria is necessary in order to improve the quality of life in these patients. Uvod/Cilj. Pod sekundarnim manifestacijama menopaze podrazumevamo klinicke manifestacije estrogene deficijencije. Prema vremenu nastanka dele se na rane i kasne. Cilj rada bio je da se uporedi ispoljavanje psihofizioloskih poremecaja u ranoj postmenopauzi kod zena sa fizioloski i imunoloski indukovanom menopauzom. Metode. Istrazivanje je sprovedeno kao prospektivna studija koja je obuhvatila 60 ispitanica starosti izmedju 40 i 55 godina, kod kojih je menopauza nastupila fizioloski (njih 30) ili su arteficijalno uvedene hirurskim putem (zbog benignih tumora genitalnih organa). Za svaku zenu je bio formiran evidencioni karton sa anamnestickim podacima, podacima o fizikalnom i ginekoloskom pregledu kao i vrednosti fizioloskih varijabli. Svakoj ispitanici su izmereni arterijski krvni pritisak, telesna visina i telesna masa, izracunat je indeks telesne mase (ITM), laboratorijski je odredjivan lipidni status i uradjen je ginekoloski pregled. Rezultati. Najucestaliji poremecaji u obe ispitivane grupe bili su vazomotorni simptomi. Prisustvo glavobolja ustanovljeno je nesto cesce kod ispitanica kod kojih je menopauza nastupila indukovanim hirurskim zahvatom. Lupanje i preskakanje srca navodile su nase ispitanice u gotovo istovetnom broju nezavisno od uzroka menopauze. Izmerene prosecne vrednosti krvnog pritiska u obe ispitivane grupe kretale su se u fizioloskim granicama. Od ostalih organskih znakova karakteristicnih za menopauzu izdvojili su se znaci atrofije koze i njenih adneksa, ucestaliji kod ispitanica sa indukovanom menopauzom. Analizom dobijenih vrednosti ITM, ispitanice iz obe grupe mogu se svrstati u grupu gojaznih zena (ITM > 25). Analizom lipidograma, u grupi kod kojih je menopauza nastupila fizioloski je konstatovana predominacija hiperlipoproteinemije tip IIa, a u grupi sa indukovanom menopauzom tip IIb. Zakljucak. Dominantni znaci menopauznog sindroma su vazomotorni i kostano-zglobni simptomi i vise su izrazeni kod zena sa indukovanom menopauzom. Znaci urogenitalne atrofije kao i ostali znaci starenja medju ispitanicama obe grupe ne pokazuju statisticki znacajne razlike u odnosu na intenzitet ispoljavanja. Hormonske promene u menopauzi, bez obzira na nacin njenog nastanka, povecavaju rizik za razvoj hiperlipoproteinemija. Ucestalost somatskih tegoba u periodu rane menopauze je veca kod zena koje su arteficijalnim putem uvedene u menopauzu. Intenzivnije pracenje i nadzor bolesnica nakon hirurskog zahvata je neophodan, kako bi se odrzao, ali i poboljsao kvalitet njihovog zivota nakon zavrsenog lecenja.