Menopausa Chirurgica vs. Fisiologica. Sessualità, Qualità di Vita e Patologie

Surgical menopause, in particular ovariectomy, is often assimilated to physiological menopause, although the endocrine environmentis different in the two conditions. Ovariectomy in premenopause induces a greater risk for osteoporotic fractures, for cardiovasculardiseases, but also for anxiety, depression, reduced libido, reduced verbal memory and possibly cerebral degenerative diseases. Ovariectomyafter the menopause may also be associated with a higher risk of cardiovascular diseases. Thus, consequences of ovariectomyshould be taken into account when proposing preventive ovariectomy for estrogen related diseases but mainly when proposed for theprevention of future ovarian neoplasm in non at risk women undergoing surgery for benign uterine diseases. In hysterectomized womenthe possibility to administer estrogens without progestins, furnishes advantages on mood, on the risk of breast cancer, and likelyon cardiovascular risk. Estrogen therapy is efficacious in preventing osteoporotic fractures and in decreasing the risk of cardiovasculardiseases. Androgen co-administration may be useful for reduced libido. Prior to perform an ovariectomy woman should be accuratelycounselled about the long term risk of the procedure and the possibility to perform an adequate prevention of these risks by estrogenand eventual androgen administration.Key words: menopause; ovariectomy