What is included in the long-term monitoring following salpingo-oophorectomy?

Updated: Feb 06, 2018
  • Author: Stacie M Ward, MD; Chief Editor: Christine Isaacs, MD  more...
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Answer

Answer

Premenopausal women who undergo a bilateral salpingo-oophorectomy are placed into surgical menopause. These patients need to be followed closely for health risks that have been associated with a lack of estrogen, including osteoporosis and cardiac disease. Patients therefore should be screened appropriately with bone density scans, cholesterol levels, blood pressure monitoring, and diabetes testing.

However, a study by Fakkert et al indicated that within the first 5 years after women with a BRCA mutation undergo risk-reducing salpingo-oophorectomy, bone mineral density and incidence of bone fracture are the same as in the general population. The study, which had a median follow-up period of 5 years, involved 212 women of premenopausal age who underwent risk-reducing salpingo-oophorectomy. The investigators determined that lumbar spine and femoral neck bone mineral densities did not fall below those of the general population, while the incidence of bone fractures (22 fractures in a total of 16 women) was no higher than that expected in the general population. Fakkert and colleagues suggested that during the first 5 years after risk-reducing salpingo-oophorectomy, it may be acceptable not to intensively screen patients for osteoporosis. [12]

A study by Stuursma et al that included 199 women who had undergone risk-reducing salpingo-oophorectomy before 52 years of age reported that 69% of the women reported moderate or severe psychological, somato-vegetative and urogenital menopausal symptoms 7.9 years after the procedure (57% reported severe urogenital symptoms and 25% reported severe psychological and/or somato-vegetative symptoms. Psychological menopausal symptoms were the only symptom to show improvement after 10 years. [13]  


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