Serum estradiol level and postmenopausal symptoms in surgical and natural menopause

Background: Menopause whether it occurs naturally or surgically is characterized by the reduced production of hormones by the ovaries. The study aimed at comparing the serum estradiol levels and postmenopausal symptoms in women with surgical and natural menopause.Methods: 50 women each of natural and surgical menopause were enrolled. Five ml of fasting blood sample was collected from each patient in both the groups by venepuncture in a plain tube, which was centrifuged and was analyzed for serum estradiol levels by chemiluminescence method. Levels of serum estradiol hormone for both the groups were compiled and the mean and standard deviation was calculated. Postmenopausal symptoms were also compared among two groups. Chi square and fisher exact test were used to analyze the qualitative data and t test were used to analyze the quantitative data.Results: The mean level of serum estradiol in women with surgical menopause was found to be 20.49 + 3.16 pg/ml while that in natural menopause, was 27.41 + 5.08pg/ml. The difference in mean estradiol level between the two groups was found to be statistically significant (p value <0.0001). Hot flushes and mood swings were observed in more number of women with surgical menopause.Conclusions: The statistically significant lower levels of serum estradiol in surgical menopausal group may be a reason behind increased presence of menopausal symptoms in this group. Thus, the women in this group may benefit from hormone replacement therapy, improving their quality of life, however further studies are needed to establish this role

A case of atypical leiomyoma mimicking as endometrial cancer

Atypical leiomyoma or leiomyoma with bizarre nucleus is diagnosed on histopathological examination characterized by severe cytological atypia in the form of nuclear enlargement, multi nucleation, hyperchromasia, coarse chromatin and prominent nuclei. These tumours do not have typical features of necrosis or mitotic figures to characterize them as leiomyosarcoma. There are 2% risk of these tumours to convert to leiomyosarcoma. 50-year P3L3A1 postmenopausal for past 6 years presented to gynaecology outpatient department (GOPD) with complains of pain in lower abdomen for past 1 year. Patient was examined and investigated. On clinical examination there was no apparent finding. On radiological examination a well-defined hypoechoic lesion of 6.4×5.7 cm2 was found arising from uterus. Contrast enhanced computed tomography (CECT) abdomen showed heterogenous mass involving endometrium and myometrium likely neoplastic. Total abdominal hysterectomy with bilateral salpingoophrectomy was done. Histopathological examination (HPE) report revealed features of atypical leiomyoma. Patient is under follow up in GOPD