Hysterectomy during the menopausal transition as a predictor of metabolic disorders

Olha Proshchenko, D.О. Govsіeіev
In: UKRAINIAN JOURNAL OF PERINATOLOGY AND PEDIATRICS · 2023 · pp. 43–48 · doi:10.15574/pp.2023.95.43 · W4388269334
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⚙ AI-generated summary by claude@2026-06, 2026-06-09 ⓘ

Hysterectomy during the menopausal transition, along with high BMI, waist circumference, age over 45, and climacteric syndrome, increases the risk of metabolic disorders one year post-surgery.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 ⓘ

This study assessed long-term metabolic consequences of hysterectomy during the menopausal transition in 160 women with benign uterine pathology, measuring carbohydrate and lipid metabolism parameters before surgery and again 12 months afterward. The authors found worsened carbohydrate metabolism, including increased HOMA-IR and postprandial glucose, along with changes in the lipid profile, and in 34.37% of cases metabolic syndrome developed one year after hysterectomy. Multivariate binary logistic regression identified higher body mass index, waist circumference >80 cm, age >45, climacteric syndrome, and hysterectomy itself as statistically significant risk factors, with combined effects increasing risk. The paper’s limitation as stated is that the evidence base motivating the study is described as fragmented and controversial, reflecting ongoing uncertainty around hormonal/metabolic changes after hysterectomy. This paper relates to endometriosis and/or adenomyosis because hysterectomy is commonly performed for benign uterine conditions that can overlap with endometriosis- or adenomyosis-associated symptoms, though the paper does not explicitly discuss endometriosis or adenomyosis.

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Abstract

Although data on the decrease in ovarian function after hysterectomy (GE) are found in literature sources, the nature of changes in the hormonal and metabolic profile, its chronological sequence, the issue of the relationship with the development of metabolic syndrome (MS), even in the case of preservation of ovarian tissue, remain controversial and fragmented, which served as an impetus for conducting this study. Purpose - to assess the risk of metabolic disorders after GE during the menopausal transition. Materials and methods. A comprehensive assessment of the long-term consequences of GE was carried out in 160 women of the menopausal transition age. Metabolic homeostasis parameters were evaluated before surgery and in dynamics after surgical intervention (after 12 months). Risk factors were identified during a general clinical examination, based on anamnestic data. Indicators of carbohydrate and lipid metabolism were evaluated in the examined women. Inclusion criteria: the age of the menopausal transition, GE due to benign uterine pathology, the patient's consent to participate in the research. Results. Analysis of carbohydrate metabolism indicators showed an increase in the HOMA-IR index and postprandial glucose level, changes in the lipid profile. When comparing clinical symptoms and laboratory research methods, in 34.37% of cases, the formation of MS was noted one year after GE. Based on multivariate analysis using binary logistic regression, the following risk factors for metabolic disorders were found to be statistically significant: high body mass index, waist circumference above 80 cm, age older than 45, climacteric syndrome, GE. Conclusions. A high body mass index, a waist circumference greater than 80 cm, the presence of signs of the climacteric syndrome, GE and age older than 45 years show the association with the development of metabolic disorders in the distant postoperative period, and their combined effect increases the risk of their development. These factors at the preoperative stage can serve as prognostic markers of metabolic disorders in the distant postoperative period. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

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