A comparison of health-related quality of life (HRQOL) after natural and surgical menopause

Abstract

Objective: To compare the health-related quality of life (HRQOL) of women at surgical menopause with that of women at natural menopause, utilizing the Menopause Rating Scale (MRS-II).

Study design: An institution-based cross-sectional study design was used, with 32 participants in each of two groups: women who had undergone surgical menopause of 9-12 months previously; and women who were more than 40 years of age and had had oligomenorrhoea for at least 1 year. The MRS-II was used to assess HRQOL. None of the women had received any hormonal therapy before assessment.

Main outcome measures: Total MRS-II scores along with the scores on the somato-vegetative, psychological and urogenital sub-scales were compared between the two groups.

Results: HRQOL was rated as worse by the surgical menopause group than by the natural menopause group: the total MRS-II scores were much higher for the surgical menopause group (mean=29.4, SD=6.7) than for natural menopause group (mean=20.7, SD=6.5), and this difference was significant (p<0.0001). Similar results were obtained on the three sub-scales-somato-vegetative (p=0.030), psychological (p<0.0001) and urogenital (p<0.0001).

Conclusion: HRQOL is worse after surgical than in natural menopause. Routine surgical castration at hysterectomy should be avoided because of adverse short-term effects and, potentially, long-term consequences.