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Hormonal patterns in postmenopausal women during gynecological surgery
M Eriksson-Mjöberg1, A Olund, K Carlström
1Department of Anesthesiology and Intensive Care, Karolinska Institutet, Huddinge University Hospital, Sweden.
Gynecologic and Obstetric Investigation
|January 1, 1997
Summary
Surgical trauma impacts endocrine function, altering adrenocortical steroids and total estrone levels post-surgery. These changes suggest a shift in steroid production and potential bowel function impairment after vaginal prolapse repair.
Area of Science:
- Endocrinology
- Surgical Physiology
Background:
- The endocrine response to surgical trauma is not fully understood.
- Postmenopausal women undergoing gynecological surgery experience significant physiological changes.
Purpose of the Study:
- To investigate the dynamic changes in serum steroid profiles following surgical trauma.
- To elucidate the endocrine effects of vaginal prolapse repair surgery in postmenopausal women.
Main Methods:
- Serum levels of cortisol, 17 alpha-hydroxyprogesterone (17-OHP), dehydroepiandrosterone (DHA), 4-androstene-3,17-dione (A4), and total estrone (tE1) were measured.
- Measurements were taken before, during, and up to 6 days after surgery in 30 postmenopausal women.
Main Results:
- Adrenocortical steroids (cortisol, 17-OHP, A4) increased during and immediately after surgery, resembling an ACTH challenge.
- Dehydroepiandrosterone (DHA) levels were normal or decreased in the late postoperative period.
- Total estrone (tE1) levels increased post-surgery, correlating with A4 in the early phase, and potentially linked to impaired bowel function later.
Conclusions:
- Postoperative endocrine changes suggest a shift in intra-adrenal steroid production favoring cortisol.
- Elevated postoperative total estrone may indicate impaired bowel function and altered enterohepatic circulation.
- Understanding these endocrine shifts is crucial for managing surgical patients.