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The timing of natural menopause after uterine fibroid embolization: a prospective cohort study
Giovanna Tropeano1, Sonia Amoroso, Carmine di Stasi
1Department of Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Rome, Italy. giovanna.tropeano@rm.unicatt.it
Objective:
To determine whether uterine fibroid embolization before the age of 45 years advances the timing of natural menopause.
Design:
Prospective cohort study.
Setting:
University tertiary-care center.
Participant(S):
Forty-three regularly cycling women aged 35-44 years who underwent embolization and 43 age-matched control subjects.
Intervention(S):
Annual assessments of menopausal status using prospectively recorded menstrual diaries and hormonal (serum FSH and E(2)) and ultrasound measures (ovarian volume and antral follicle count). Women were followed for 7 years or until they reached menopause.
Main Outcome Measure(S):
Age at menopause as computed by subtracting the date of birth from the exact date of the last menstrual period.
Result(S):
Over the study period, 9 patients (25%) and 12 control subjects (33%) became menopausal, 19 patients (53%) and 18 control subjects (50%) entered the menopausal transition (irregular cycles), and 8 patients (22%) and 6 control subjects (17%) continued to menstruate regularly. Mean menopausal age in the embolization group (48.94 ± 2.48 years) was not significantly different from that in the control group (49.52 ± 1.25 years). There was no significant difference of menopause occurrence between the groups. Longitudinal changes in hormonal and ultrasound measures were similar for the two groups.
Conclusion(S):
This long-term follow-up study found no evidence for fibroid embolization advancing the timing of menopause in women before the age of 45 years.
