Changes of hormone levels for postmenopausal women after bilateral oophorectomy: A meta-analysis

Bilateral oophorectomy has a significant effect on changes in hormone levels in postmenopausal women. This meta-analysis aimed to evaluate the effects of bilateral oophorectomy on estradiol, testosterone, androstenedione, dehydroepiandrosterone sulfate (DHEAS), dehydroepiandrosterone (DHEA), sex hormone-binding globulin (SHBG), and estrone levels.

We conducted a search for studies on focused ultrasound for cervical high-grade squamous intraepithelial lesions in PubMed, EMBASE, Web of Science, and Cochrane Library databases. This review included 7 studies related to bilateral ovariectomy or retention in postmenopausal women. Using Stata software version 12.0, we applied the random effect model, fixed effect model, and subgroup analysis to evaluate the change of different hormones.

After bilateral ovariectomy, estradiol levels decreased significantly (standardized mean difference [SMD] = -0.26, 95% confidence interval [CI] [-0.50, -0.02], P = .031). The overall analysis did not show significant differences (SMD = -0.10, 95% CI [-0.46, 0.26], P = .585), although significant differences were observed between subgroups (P = .025). Testosterone levels also decreased significantly after bilateral ovariectomy (SMD = -0.58, 95% CI [-0.86, -0.31], P < .001). The overall analysis indicated a significant difference between the 2 groups (SMD = -0.35, 95% CI [-0.63, -0.07], P = .014). DHEA levels decreased significantly after bilateral ovariectomy (SMD = -0.51, 95% CI [-0.93, -0.10], P = .015). In contrast, the hormone levels of androstenedione, DHEAS, SHBG, and estrone did not show significant differences between the 2 groups: androstenedione (SMD = -0.04, P = .682), DHEAS (SMD = -0.07, P = .489), SHBG (SMD = -0.02, P = .781), and estrone (SMD = -0.04, P = .587).

The present meta-analysis showed that bilateral ovariectomy had a significant effect on both estrogen and androgen levels in postmenopausal women, especially estradiol, testosterone, and DHEA. In contrast, the changes in androstenedione, DHEAS, SHBG, and estrone were not obvious. The findings of this study underscore the importance of monitoring hormone levels in postmenopausal women in clinical practice and considering the impact of oophorectomy on women's long-term health when developing individualized treatment options.