Association between body mass index and surgical menopausal symptoms in patients with early stage endometrial cancer

Objectives: Premenopausal women may undergo surgical menopause after staging for their endometrial cancer. Our aim was to determine the association between body mass index (BMI) and surgical menopausal symptoms. Methods: We report a retrospective review of endometrial cancer patients whom underwent menopause secondary to their surgical staging procedure. Symptoms were classified as severe if treatment was prescribed, or mild if treatment was offered, but declined. Univariate analysis was performed with ANOVA and Chi-square tests as appropriate. Relative risks (RR) were generated from Poisson regression models. Results: We identified 166 patients in whom the BMI (kg/m²) distribution was as follows: 33 (19.9%) had BMI <30, 49 (29.5%) had BMI 30–39.9, 50 (30.1%) had BMI 40–49.9, and 34 (20.5%) had BMI ≥50. There were no differences in race, age, or adjuvant treatment among the groups. Overall, 65 (39.2%) women reported symptoms of surgical menopause, including 19 (11.4%) mild and 46 (27.7%) severe. Symptom type did not differ by BMI; however, the prevalence of severe menopausal symptoms decreased with increasing BMI: <30 (45.5%), 30–39.9 (30.6%), 40–49.9 (22%), and ≥ 50 (14.7%); P = 0.002. Multivariate analysis confirmed that symptom prevalence decreased with increasing BMI. Compared to women with a BMI of <30, those with a BMI 40–49.9 (RR = 0.39, 95% CI: 0.17–0.87) or ≥ 50 (RR = 0.24, 95% CI: 0.08–0.70) were significantly less likely to experience menopausal symptoms. Conclusions: Women younger than 50 with BMI >40 and stage I endometrial cancer are significantly less likely than women with BMI <30 to experience menopausal symptoms after oophorectomy. This information may assist in peri-operative counseling.