[Changes in bone mineral density and bone turnover within 12 months after oophorectomy: a prospective study compared...

Nineteen patients (pts) with stage Ib to IIb uterine cervical cancer were studied for changes in bone mineral density and bone turnover within 12 months after radical hysterectomy and pelvic lymphadenectomy. Eleven out of 19 pts also underwent oophorectomy (OX), and the other 8 pts without OX were studied as controls. A significant increase in FSH and decrease in E2 (p less than 0.01) in OX pts indicated the completeness of oophorectomy, whereas no significant change in those levels showed retained ovarian function in the controls. In OX pts significantly increased serum alkaline phosphatase (p less than 0.01), urine-calcium/creatinine (p less than 0.05) and hydroxyproline/creatinine ratio (p less than 0.01) indicating high bone turnover after the oophorectomy were observed. However, a transient but significant (p less than 0.05) rise in these levels in the 3rd month in the controls was noted. In OX pts the spinal bone mineral density (BMD) measured by dual photon absorptiometry was significantly reduced to approximately 10% (p less than 0.05) within 12 months after oophorectomy, while in the controls loss of BMD was also observed up to 6 months, and it appeared to have returned towards baseline levels at 12 months after hysterectomy. These data suggest that a rapid and considerable loss of spinal BMD was mainly accelerated by the oophorectomy, but in part was contributed to by the stress or reduced physical activity for up to 6 months after radical hysterectomy.