Skip to main content
SpringerLink
Log in

The effect of surgical menopause after bilateral oophorectomy on hormonal changes, mucociliary clearance, and quality of life

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

The removal of the ovaries for any reason causes surgical menopause. Hormonal changes that occur progressively over 5–10 years in natural menopause occur acutely in surgical menopause. Signs of estrogen deficiency appear suddenly and are permanent after this surgery. This study investigated the short- and long-term effects of estrogen deficiency occurring after surgical menopause on both nasal mucociliary activity and sinonasal symptoms.

Methods

This prospective study included women aged 20–45 years who were not in the menopause, who had a planned bilateral oophorectomy and who attended the Gynecology Clinic at the Faculty of Medicine at a university hospital between January 2018 and December 2019. The nasal mucociliary clearance time, and blood Estradiol (E2) and FSH levels were measured once in the preoperative period, and at the postoperative 3rd, 6th, 9th, and 12th months. At the same times, the Sinonasal Outcome Test 22 (SNOT-22) was also applied.

Results

 The average age of the 47 patients was 41.2 ± 2.7. The mean serum estradiol levels of the women were 164.7 ± 63.4 pg/ml in the preoperative period, 14.8 ± 3.7 pg/ml at the postoperative 3rd month, 12.5 ± 3.5 pg/ml at the postoperative 6th month, 11.6 ± 3.0 pg/ml at the postoperative 9th month, and 11.1 ± 2.7 pg/ml at the postoperative 12th month. The mean FSH levels of the women were 9.4 ± 2.4 mIU/ml in the preoperative period, 60.5 ± 9.6 mIU/ml at the postoperative 3rd month, 61.9 ± 9.4 mIU/ml at the postoperative 6th month, 63.0 ± 9.3 mIU/ml at the postoperative 9th month, and 64.6 ± 8.7 mIU/ml at the postoperative 12th month. The changes in postoperative mean estradiol and FSH levels over a year were significant and consistent with menopausal symptoms (p < 0.001). The mean mucociliary clearance times were 12.6 ± 1.2 before menopause, 13.2 ± 1.7 at the postoperative 3rd month, 14.5 ± 1.7 at the postoperative 6th month, 17.5 ± 1.6 at the postoperative 9th month, and 19.4 ± 1.9 at the postoperative 12th month. The extension of the mean mucociliary clearance time over 1 year was significant (p < 0.001). The mean scores for the SNOT-22 were 17.3 ± 6.9 before the operation, 17.8 ± 6.0 at the postoperative 3rd month, 19.6 ± 6.9 at the postoperative 6th month, 23.4 ± 10.4 at the postoperative 9th month, and 36.1 ± 10.0 at the postoperative 12th month. The mean scores for rhinologic symptoms were 5.2 ± 1.9 (3–11) in the preoperative period, 5.7 ± 2.0 (3–12) at the postoperative 3rd month, 7.1 ± 2.3 (4–14) at the postoperative 6th month, 9.3 ± 3.3 (4–16) at the postoperative 9th month, and 11.9 ± 3.3 (6–18) at the postoperative 12th month. The 1-year change in the SNOT-22 scores was found to be significant (p < 0.001).

Conclusion

After bilateral oophorectomy, menopausal hormonal values were acutely high in women. At the 1-year postmenopausal follow-up, the mean scores for the SNOT-22 had increased significantly. In other words, quality of life decreased in parallel with prolonged nasal mucociliary clearance time.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Rodríguez M, Shoupe D (2015) Surgical menopause. Endocrinol Metab Clin N Am 44:531–542. https://doi.org/10.1016/j.ecl.2015.05.003

    Article  Google Scholar 

  2. Parker WH, Jacoby V, Shoupe D, Rocca W (2009) Effect of bilateral oophorectomy on women’s long-term health. Women’s Health 5:565–576. https://doi.org/10.2217/whe.09.42

    Article  PubMed  Google Scholar 

  3. Svanberg L (1981) Effects of estrogen deficiency in women castrated when young. Acta Obstetr Gynecol Scand 106:11–15

    CAS  Google Scholar 

  4. Muttukrishna S, Sharma S, Barlow DH, Ledger W, Groome N, Sathanandan M (2002) Serum inhibins, estradiol, progesterone and FSH in surgical menopause: a demonstration of ovarian pituitary feedback loop in women. Hum Reprod 17(10):2535–2539. https://doi.org/10.1093/humrep/17.10.2535

    Article  CAS  PubMed  Google Scholar 

  5. Hendrix SL (2005) Bilateral oophorectomy and premature menopause. Am J Med 118(12):131–135. https://doi.org/10.1016/j.amjmed.2005.09.056

    Article  PubMed  Google Scholar 

  6. Munkholm M, Mortensen J (2014) Mucociliary clearance: pathophysiological aspects. Clin Physiol Funct Imaging 34(3):171–177. https://doi.org/10.1111/cpf.12085

    Article  PubMed  Google Scholar 

  7. Bustamante-Marin XM, Ostrowski LE (2017) Cilia and mucociliary clearance. Cold Spring Harb Perspect Biol 9(4):a028241. https://doi.org/10.1101/cshperspect.a028241

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Haeggström A, Ostberg B, Stjerna P, Graf P, Hallén H (2000) Nasal mucosal swelling and reactivity during a menstrual cycle. ORL J Otorhinolaryngol Relat Spec 62(1):39–42. https://doi.org/10.1159/000027713

    Article  PubMed  Google Scholar 

  9. Kabil Kucur S, Seven A, Yuksel B, Kucur C, Sencan H, Gozukara I, Keskin N (2016) Alterations in nasal mucociliary activity in polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol 207:169–172. https://doi.org/10.1016/j.ejogrb.2016.10.023

    Article  PubMed  Google Scholar 

  10. Karaer I, Tuncay G (2020) The effect of premature ovarian insufficiency on nasal mucociliary clearance time. Gynecol Endocrinol 36(1):36–39. https://doi.org/10.1080/09513590.2019.1631275

    Article  PubMed  Google Scholar 

  11. Philpott CM, Conboy P, Al-Azzawi F, Murty G (2004) Nasal physiological changes during pregnancy. Clin Otolaryngol Allied Sci 29(4):343–351. https://doi.org/10.1111/j.1365-2273.2004.00815.x

    Article  CAS  PubMed  Google Scholar 

  12. Soylu Özler G, Akbay E, Akkoca AN, Karapınar OS, Şimşek GÖ (2014) Does menopause effect nasal mucociliary clearance time? Eur Arch Otorhinolaryngol 272(2):363–366. https://doi.org/10.1007/s00405-014-3118-z

    Article  PubMed  Google Scholar 

  13. Philpott CM, Wild DC, Wolstensholme CR, Murty GE (2008) The presence of ovarian hormone receptors in the nasal mucosa and their relationship to nasal symptoms. Rhinology 46(3):221–225

    CAS  PubMed  Google Scholar 

  14. Costa HO, Castro Neto NP, Rossi LM, Millas I, Coelho F, Silva LD (2014) Influence of estradiol administration on estrogen receptors of nasal mucosa: an experimental study on guinea pigs. Braz J Otorhinolaryngol 80(1):18–23. https://doi.org/10.5935/1808-8694.20140006

    Article  PubMed  Google Scholar 

  15. Levin ER (2011) Ekstranükleer steroid reseptörleri: hücre fonksiyonlarının modülasyonu rolleri. Mol Endokrinol 25:377–384

    Article  CAS  Google Scholar 

  16. Nappi C, Di Spiezio SA, Guerra G, Di Carlo C, Bifulco G, Acunzo G, Sammartino A, Galli V (2004) Comparison of intranasal and transdermal estradiol on nasal mucosa in postmenopausal women. Menopause 11(4):447–455. https://doi.org/10.1097/01.gme.0000113849.74835.53

    Article  PubMed  Google Scholar 

  17. Gudis D, Zhao KQ, Cohen NA (2012) Acquired cilia dysfunction in chronic rhinosinusitis. Am J Rhinol Allergy 26(1):1–6. https://doi.org/10.2500/ajra.2012.26.3716

    Article  PubMed  PubMed Central  Google Scholar 

  18. Baroody FM (2007) Mucociliary transport in chronic rhinosinusitis. Clin Allergy Immunol 20:103–119. https://doi.org/10.1007/BF02996761

    Article  PubMed  Google Scholar 

  19. Cingi C, Altin F, Cakli H, Entok E, Gurbuz K, Cingi E (2005) Scintigraphic evaluation of nasal mucociliary activity in unilateral chronic otitis media. J Laryngol Otol 119(6):443–447. https://doi.org/10.1258/0022215054273098

    Article  PubMed  Google Scholar 

  20. Cakir Cetin A, Kumus O, Keskinoglu P, Sutay S, Ecevit MC (2019) Turkish validation of the Sino-Nasal Outcome Test-22. Clin Otolaryngol 44(4):557–564. https://doi.org/10.1111/coa.13332

    Article  PubMed  Google Scholar 

  21. Gillett S, Hopkins C, Slack R, Browne JP (2009) A pilot study of the SNOT 22 score in adults with no sinonasal disease. Clin Otolaryngol 34(5):467–469. https://doi.org/10.1111/j.1749-4486.2009.01975.x

    Article  CAS  PubMed  Google Scholar 

  22. Tait SD, Kallogjeri D, Chidambaram S, Schneider J, Piccirillo JF (2019) Psychometric and clinimetric validity of the modified 25-item sino-nasal outcome test. Am J Rhinol Allergy 33(5):577–585. https://doi.org/10.1177/1945892419851622

    Article  PubMed  Google Scholar 

  23. Dejaco D, Riedl D, Huber A, Moschen R, Giotakis AI, Bektic-Tadic L, Steinbichler T, Kahler P, Riechelmann H (2019) The SNOT-22 factorial structure in European patients with chronic rhinosinusitis: new clinical insights. Eur Arch Otorhinolaryngol 276(5):1355–1365. https://doi.org/10.1007/s00405-019-05320-z

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Lange B, Thilsing T, Baelum J, Kjeldsen AD (2016) The sinonasal outcome test 22 score in persons without chronic rhinosinusitis. Clin Otolaryngol 41(2):127–130. https://doi.org/10.1111/coa.12481

    Article  CAS  PubMed  Google Scholar 

  25. Phillips KM, Hoehle LP, Caradonna DS, Gray ST, Sedaghat AR (2019) Determinants of noticeable symptom improvement despite sub-MCID change in SNOT-22 score after treatment for chronic rhinosinusitis. Int Forum Allergy Rhinol 9(5):508–513. https://doi.org/10.1002/alr.22269

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Ege University Atatürk Health Care Vocational School, 35100, Bornova, Izmir, Turkey

    Sureyya Gumussoy

  2. Department of Otolaringology Head and Neck Surgery, University of Health Sciences, Izmir Tepecik Training and Research Hospital, Güney mahallesi 1140/1 sokak no: 1 Yenişehir, Konak, Izmir, Turkey

    Murat Gumussoy

  3. Department of Obstetrics and Gynecology, Faculty of Medicine, Ege University, Bornova, Izmir, Turkey

    Ismet Hortu & Ahmet Mete Ergenoglu

Authors
  1. Sureyya Gumussoy
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Murat Gumussoy
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ismet Hortu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ahmet Mete Ergenoglu
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Concept: SG and MG; design; SG and MG; materials: SG, IH, and AME; statistics: SG; writer: SG and MG.

Corresponding author

Correspondence to Murat Gumussoy.

Ethics declarations

Conflict of interest

This manuscript has not been published elsewhere and that it has not been submitted simultaneously for publication elsewhere. The authors also declare that they have no competing interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gumussoy, S., Gumussoy, M., Hortu, I. et al. The effect of surgical menopause after bilateral oophorectomy on hormonal changes, mucociliary clearance, and quality of life. Eur Arch Otorhinolaryngol 277, 2793–2800 (2020). https://doi.org/10.1007/s00405-020-06164-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-020-06164-8

Keywords

Search

Navigation