Retention of ovaries and oxidative stress of surgery

Surgical menopause results in severe menopausal symptoms due to the sudden withdrawal of estrogen. This study evaluated the impact of surgical menopause on oxidant and antioxidant status.

Thirty eight women who underwent total hysterectomy with or without bilateral salpingo-oophorectomy were included. Oxidant status was assessed by measuring plasma levels of malondialdehyde (MDA) and antioxidant status by assessing glutathione (GSH) and estrogen levels.

The levels of MDA were increased in all women, and GSH levels were significantly decreased in women who underwent hysterectomy alone but significantly increased in those who also had oophorectomy. Estrogen levels were increased if the ovaries were retained even in postmenopausal women, while they were decreased in the women who underwent oophorectomy.

Oxidative stress of surgery, as assessed by increased MDA levels, occurred in all women. After oophorectomy, estrogen levels decreased and GSH levels increased in both premenopausal and postmenopausal women. The ovaries may therefore respond to oxidative stress of surgery by increasing estrogen production, estrogen being a better antioxidant than GSH.