Osteodencytometric Diagnostics in Women with Oophorectomy

Abstract

Oophorectomy, particularly bilateral, is associated with a significant risk of bone mineral density (BMD) loss due to abrupt oestrogen deficiency. This study aimed to assess the effectiveness of osteodensitometric diagnostics in detecting early post-oophorectomy bone demineralisation in women. A total of 62 women aged 35–60 years who had undergone unilateral or bilateral oophorectomy were evaluated using dual-energy X-ray absorptiometry (DEXA). The results showed that 45.2% had osteopenia and 24.2% had osteoporosis, with more severe BMD loss observed in those with bilateral oophorectomy and greater time elapsed since surgery. The lumbar spine showed the most significant decline. A negative correlation was found between BMD and both the time since oophorectomy and serum oestradiol levels. These findings highlight the importance of early DEXA screening and long-term monitoring in surgically menopausal women, particularly in those without hormone replacement therapy, to prevent osteoporosis and its complications.

Introduction

Oophorectomy, the surgical removal of one or both ovaries, significantly increases the risk of bone mineral density (BMD) loss, particularly in premenopausal women, due to the abrupt decline in oestrogen, a hormone vital for bone health. This leads to accelerated bone resorption, resulting in osteopenia or osteoporosis, often without early symptoms.

Study Purpose:

This prospective observational study evaluated changes in BMD among 62 women (aged 35–60) who had undergone unilateral or bilateral oophorectomy. It aimed to assess the role of DEXA scans (dual-energy X-ray absorptiometry) in detecting early bone loss and to identify clinical factors influencing BMD post-surgery.

Key Findings:

1. BMD Results:

• Osteopenia: 45.2% of women

• Osteoporosis: 24.2%

• Normal BMD: 30.6%

• Bilateral oophorectomy was associated with significantly more osteoporosis than unilateral (32.4% vs. 12.0%, p = 0.03).

• Lumbar spine showed more severe bone loss than the femoral neck (T-score: -1.86 vs. -1.48).

2. Time-Dependent Bone Loss:

• Bone loss worsened over time since oophorectomy:

  • <1 year: 9.1% had osteoporosis

  • 1–3 years: 25%

  • 3 years: 38.1%

• Strong negative correlation between time post-surgery and BMD (r = -0.48 for spine, p < 0.01).

3. Hormonal & Lifestyle Factors:

• 80% of women with osteoporosis had undetectable or low oestradiol.

• Osteoporosis group had:

  • Lower calcium intake

  • Higher physical inactivity

  • More smoking (though not statistically significant)

Discussion & Clinical Implications:

• The study confirms that oestrogen deficiency after oophorectomy leads to rapid, progressive bone loss—especially in the spine, where trabecular bone is most sensitive.

• Bilateral oophorectomy poses greater risk, particularly if done before natural menopause.

• Despite clear risks, DEXA screening is underused, especially in women without cancer history.

• Routine BMD screening post-oophorectomy—within the first year—is essential for early intervention.

• Lifestyle modification, along with HRT or bone-protective therapies, should be part of follow-up care.

Conclusion

Oophorectomy, especially bilateral, significantly increases the risk of early, silent bone loss. This study strongly supports the use of DEXA scans for routine BMD screening post-surgery, particularly in women not receiving hormone therapy. Early detection enables timely treatment, reducing long-term fracture risk and preserving bone health.

References

[1] Anderson, G. L., Limacher, M., Assaf, A. R., et al. (2004). Effects of conjugated equine estrogen in postmenopausal women with hysterectomy: The Women\'s Health Initiative randomized controlled trial. JAMA, 291(14), 1701–1712. [2] Babich, L. V., & Petrova, T. N. (2019). ?????? ??????????? ????????? ??????? ????? ? ?????? ????? ????????????. ??????????? ???????????, 4(12), 25–30. [3] Banu, J., & Arjmandi, B. H. (2014). Exercise and osteoimmunology: A reciprocal relationship. Immunologic Research, 58(1), 51–60. [4] Cummings, S. R., & Melton, L. J. (2002). Epidemiology and outcomes of osteoporotic fractures. The Lancet, 359(9319), 1761–1767. [5] Gulyamova, D. R., & Raxmatova, N. I. (2021). Postooforektomiya sindromi bo‘lgan ayollarda osteopeniya va osteoporozni erta aniqlashda densitometriyaning diagnostik roli. Tibbiyotda Innovatsiyalar, 3(6), 51–54. [6] Kanis, J. A. (2008). Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: Synopsis of a WHO report. Osteoporosis International, 4(19), 385–391. [7] Karpova, O. V., & Lobanova, T. E. (2020). ?????????? ? ?????? ? ????????????? ?????????: ???? ????????????? ? ???????????? ?????????. ??????????? ????????????, 12(3), 14–19. [8] Manolagas, S. C. (2000). Birth and death of bone cells: Basic regulatory mechanisms and implications for the pathogenesis and treatment of osteoporosis. Endocrine Reviews, 21(2), 115–137. [9] Mirsaidova, M. Z. (2020). Ayollarda osteoporozni oldini olishda erta densitometrik diagnostikaning ahamiyati. O‘zbekiston Tibbiyot Jurnali, 5(130), 58–61. [10] NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy. (2001). Osteoporosis prevention, diagnosis, and therapy. JAMA, 285(6), 785–795. [11] Raisz, L. G. (2005). Pathogenesis of osteoporosis: Concepts, conflicts, and prospects. Journal of Clinical Investigation, 115(12), 3318–3325. [12] Utkin, V. Y., & Zharov, A. I. (2018). ?????????? ????????????? ? ??????????? ????????: ??????????? ? ???????? ????????????? ??????? ???????????. ?????? ??????????? ????????, 7(2), 112–118. ????????, ?. ?. (2022). ???????-??????????????? ????????? ? ??????? ?????????? ? ????????? ???????????. Science and Education, 3(12), 175-181. Madasheva, A. G., Yusupova, D. M., & Abdullaeva, A. A. EARLY DIAGNOSIS OF HEMOPHILIA A IN A FAMILY POLYCLINIC AND THE ORGANIZATION OF MEDICAL CARE. ?????? XXI ????, 37. Turdiyev, Q., Maxmonov, L., Xaqberdiyev, Z., & Madasheva, A. (2025). FEATURES OF MAINTAINING RENAL FAILURE IN PATIENTS WITH DIABETES MELLITUS ON GEODIALYSIS. International Journal of Artificial Intelligence, 1(1), 1481-1486. ????????, ?. ?., ??????, ?. ?., ?????????, ?. ?., ??????, ?. ?., & ???????, ?. A. (2025). ????????????? ??????????????? ??????????? ???????????, ?????????, ?????????? 2 ??????????????? ?????????????????? ??????-???????????? ??????????? ????? ???????????, ???????, ??????????. Laboratory Diagnostics Eastern Europe, 87. ??????, ?. ?., ?????????, ?. ?., ????????, ?. ?., & ????????, ?. ?. (2023). ??????????? ????????????????? ????????? ? ?????? ????????????????? ??? ??????????? ? ???. ?????? ???????????? ? ???????????? ????, (5), 43-46.

Copyright

Copyright © 2025 Hikmatov Bakhtiyor Alisherovich, Makhmonov Lutfullo Saydullaevich, Kholikulov Bahodir Erkulovich, Madasheva Anajan Gazkhanovna. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.