title: Relation between body mass and postmenopausal symptoms in surgically castrated women.
abstract: BACKGROUND
  Post-menopause androgens are the essential precursors for estrogen synthesis through their conversion in peripheral tissues. The main postmenopausal estrogen is estrone, which is also peripherally converted into estradiol. Concentrations of these two estrogens are directly proportional in circulation. We wanted to establish whether there is a direct correlation between body mass and postmenopausal symptoms in surgically castrated women.
  
  
  METHODS
  We analyzed 30 patients with artificially induced menopause, 3-12 months after the operation (hysterectomy and bilateral adnexectomy). Prior to being put on hormone substitution therapy the following was obtained from the patients: Body Mass Index--BMI (kg/m(2)), measurement of estradiol (E(2)) by RIA method, and 12 subjective symptoms analyzed according to intensity and frequency. The relationship between BMI, E(2) level and subjective symptoms were assessed.
  
  
  RESULTS
  By analyzing the correlation coefficient it was shown that there was statistically significant causal-consequential connection between the E(2) level and BMI (R(2)=0.1647, p<0.05). There is no strong correlation between BMI and symptoms (R(2)=0.004, p<0.05). However, E(2) level correlated with subjective symptoms (R(2)=0.2123, p<0.05).
  
  
  CONCLUSIONS
  Estrogen production in postmenopause is dependent on the substrate availability, and thus with adiposity. Therefore, we were surprised by the lack of correlation between BMI and symptoms. This suggests that estrogen metabolism and biological effects are not primarily affected by BMI, and that expression of postmenopausal symptoms does not depend only on estrogen level.
authors.affiliation: Gynecology-Obstetrics Clinic Narodni front, Belgrade University Medical School, Serbia and Montenegro. stefand@EUnet.yu
authors.forename: Svetlana
authors.initials: S
authors.lastname: Dragojević
authors.forename: Ana
authors.initials: A
authors.lastname: Mitrović
authors.forename: Tomislav
authors.initials: T
authors.lastname: Jovanović
authors.forename: Srdjan
authors.initials: S
authors.lastname: Dikić
mesh_terms: D000328:Adult; D015992:Body Mass Index; D004958:Estradiol / Q000097:blood*; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D009214:Myoma / Q000601:surgery; D010052:Ovariectomy; D017698:Postmenopause; D014594:Uterine Neoplasms / Q000601:surgery
chemical_list: D004958:Estradiol