THE EFFECT OF HYSTERECTOMY AND ENDOMETRIAL ABLATION ON FOLLICLE-STIMULATING-HORMONE (FSH) LEVELS UP TO 1 YEAR AFTER SURGERY

Objectives: In this study the hypothesis was tested, that in premenopa usal patients FSH-levels would rise after 'simple hysterectomy'. As en dometrial ablation is not supposed to compromise ovarian bloodflow, th ere would be no such change in ablated patients. Methods: Between Janu ary 1995 and April 1996, consecutive premenopausal patients with dysfu nctional uterine bleeding who were scheduled for hysterectomy or endom etrial ablation were asked to participate in the study. Bloodsamples w ere drawn before surgery, six weeks, six months and one year after sur gery. FSH and oestradiol (E2) were assayed. In all patients data about length and weight were collected to calculate Body Mass Index (BMI). Every visit patients filled in a questionnaire, containing questions a bout typical climacteric complaints, combined in a five-point scale. R esults: Except for a significant difference in preoperative FSH-level between both groups, there were no significant differences regarding a ge, Body Mass Index (BMI), oestradiol (E2) or the percentage of women with vasomotor complaints. Compared to the preoperative starting level , six weeks, six months and one year after surgery a significant rise in serum FSH in the hysterectomy group, as well as in the ablation gro up was found. However there was no significant difference in FSH incre ase between both groups. One third of the patients in both groups had typical climacteric complaints as flushing and nocturnal sweating. Con clusions: Assaying serum FSH-levels before and after uterine surgery a nd comparing hysterectomized patients and patients after endometrial a blation, we found a significant rise in FSH-level up to one year after surgery in both groups postoperatively, indicating impaired ovarian f unction. There was no difference in FSH-levels between both groups. Th erefore major uterine surgery (hysterectomy, ablation) may prelude an earlier onset of menopause. (C) 1998 Elsevier Science Ireland Ltd. All rights reserved.