Follow-up of Ovarian Endocrine Function in Premenopausal Women After Hysterectomy by Daily Measurements of Salivary Progesterone

Objective: The effect of hysterectomy on ovarian endocrine function of premenopausal women was studied.

Design: The patients collected daily salivary samples during one preoperative cycle (1), the cycle of operation (2), the subsequent period of 30 days (3) and the cycle 6 months after operation (4).

Patients: Forty-one premenopausal women (aged 33-48 years) undergoing hysterectomy were studied; their preoperative cycles served as controls. The patients were also compared with a reference group of 17 younger fertile women.

Measurements: Salivary progesterone levels were measured by radioimmunoassay.

Results: Cycle 1 was more frequently short (P less than 0.01), with short luteal phase (P less than 0.01) and low progesterone secretion (P less than 0.05), than the cycles of younger women. Cycle 2 was longer than the other cycles (P less than 0.01), due to prolonged follicular phase (P less than 0.01). Cycle 3 differed from cycle 1 by the lesser frequency of short cycles (P less than 0.01). Cycle 4 and its follicular phase were longer than those measured in cycle 1 (P less than 0.05). Of the women with normal cycle 1, 39% (P less than 0.01) presented with luteal insufficiency (LPD, low luteal progesterone secretion) or anovulation (8%) in at least one of cycles 2 to 4. The frequency of LPD or anovulation was significantly higher in cycle 3 (P less than 0.05) but not in cycle 4, compared to 1.

Conclusions: Acute luteal progesterone deficiency after hysterectomy in premenopausal women is common but in most cases reversible.