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. 2022 Apr 27;22(1):134.
doi: 10.1186/s12905-022-01711-3.

Relationship between bone mineral density and ovarian function and thyroid function in perimenopausal women with endometriosis: a prospective study

Mari Uehara  1 , Osamu Wada-Hiraike  2 , Mana Hirano  1 , Kaori Koga  1 , Noriko Yoshimura  3 , Sakae Tanaka  4 , Yutaka Osuga  1
Affiliations

Relationship between bone mineral density and ovarian function and thyroid function in perimenopausal women with endometriosis: a prospective study

Mari Uehara et al. BMC Womens Health. .

Abstract

Background: In women with endometriosis, the association between ovarian function, hormones, and bone mineral density (BMD) is unclear. Therefore, this study aimed to elucidate the association between changes in bone mineral density (BMD) and clinical data, such as ovarian reserves, in perimenopausal women with endometriosis.

Methods: In this prospective study, we evaluated 207 female patients who visited the Department of Obstetrics and Gynecology at the University of Tokyo Hospital between December 2015 and December 2020. We included patients aged ≥ 40 years with a history of endometriosis or who presented with endometriosis lesions. Patients with a history of smoking, steroid administration, autoimmune diseases, dyslipidaemia, and heart disease were excluded. During the study period, patients who underwent two tests, an initial and a follow-up test (n = 142, average age: 45.02 years, average BMD: 1.16 g/cm2), were evaluated at regular intervals based on the annual rate of change in BMD.

Results: There was a weak negative correlation between the follicle-stimulating hormone (FSH) and BMD and a weak positive correlation between the anti-Müllerian hormone (AMH) and BMD. The annual rate of change in BMD showed a very weak correlation with thyroid-stimulating hormone (TSH) levels. A large decline in BMD was associated with high TSH levels and higher average age at menopause. Patients with higher TSH exhibited a higher rate of decrease in BMD than those without.

Conclusions: High FSH or low AMH levels are associated with decreased BMD. Decreased ovarian reserve is associated with decreased BMD in perimenopausal women with endometriosis. High TSH levels increase the risk of BMD loss. This finding may suggest that women with endometriosis should undergo bone scanning to rule out the possibility of reduced bone mass and subsequent increased risk of fracture.

Keywords: Bone mineral density; Endometriosis; Osteoporosis; Ovarian reserve; Perimenopause.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Comparison of the annual rates of change in the BMD, TSH and age at menopause. a BMD rates of change among the mild, moderate and severe groups. There were significant differences among the groups. b TSH levels in the three groups. There were significant differences among the groups. c Age at menopause in the three groups. There were significant differences among the groups. d Comparison of the relative risk ratios of TSH categorised by BMD rate of change. Values were adjusted for age and body weight. Error bars represent 95% confidence interval for the mean changes. Mild, mild bone density loss group; moderate, moderate bone density loss group; severe, severe bone density loss group; BMD, bone mineral density; TSH, thyroid-stimulating hormone. *p < 0.05
See this image and copyright information in PMC

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