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 < 0.01), with short luteal phase (P < 0.01) and low progesterone secretion (P < 0.05), than the cycles of younger women. Cycle 2 was longer than the other cycles (P < 0.01), due to prolonged follicular phase (P < 0.01). Cycle 3 differed from cycle 1 by the lesser frequency of short cycles (P < 0.01). Cycle 4 and its follicular phase were longer than those measured in cycle 1 (P < 0.05). Of the women with normal cycle 1, 39% (P < 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 < 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.