Background: Menopause comes along with a set of hormonal and physiological changes that can change cardiovascular responses during surgeries, along with altering pain perception. This research intends to analyze pain intensity during and after anesthesia and changes in hemodynamics in pre- and post-menopausal women during elective abdominal hysterectomy under general anesthesia.

Methods: Elective surgery patients, in this case, were 88 in number, with each division having 44 patients (before menopause and after). Women in each group were defined as premenopausal (n=44) and postmenopausal (n=44) in equal proportion. Other metrics looked at were Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP), also known as SpO₂. Patients’ heart rate and SpO₂ were checked during the surgery and after the surgery as well. Pain was assessed with the use of standardized scale methods, and participants were questioned on the pain felt during the post-operative period.

Results: While the premenopause cohort showed lower fluctuations in sensitivity to changes in SBP, DBP, and HR during and after anesthesia, the Postmenopause cohort exhibited the opposite (p<0.05). In each group, the SpO₂ levels were maintained within normal limits and showed no significant group differences. In the postoperative period, the pain score was significantly higher in the postmenopausal group with lower pain tolerance and a higher requirement for analgesic treatment. Spoken demographics such as age, body mass index (BMI), and other associated conditions showed a moderating influence on the hemodynamic response and pain outcomes.

Conclusion: Following menopause, diminished vascular adaptability, along with increased sympathetic tone and decreased central pain modulatory control due to lack of estrogen, might explain the instability of hemodynamics and increased postoperative pain. These observations could help in the formulation of appropriate anaesthetic techniques and postoperative pain relief policies in relation to the reproductive status of women.