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Hysterectomy does not appear to diminish long-term life satisfaction among older women

About one-third of women in the United States have a hysterectomy by the age of 60. Fortunately, this operation doesn't seem to diminish their long-term life satisfaction, concludes a study supported in part by the Agency for Healthcare Research and Quality (HS06726).

In a 1992 survey, women aged 55-94 years were asked to rate their life satisfaction as better, the same, or worse after menopause or hysterectomy compared with before. Nearly one-fourth (23 percent) of the 1,177 women who responded to the mailed survey had undergone a hysterectomy with bilateral oophorectomy (uterus and both ovaries removed) an average of 24 years earlier, and 26 percent reported hysterectomy with ovarian conservation an average of 28 years earlier.

Women who were 20 or more years posthysterectomy or postmenopause were significantly more likely to rate their life satisfaction as better than were women 5 or fewer years after these events. Among women with a hysterectomy, 53 percent with oophorectomy and 60 percent with ovarian conservation rated life satisfaction better after the surgery. Only 42 percent of women who had not had a hysterectomy rated life satisfaction as better after menopause. These differences persisted, even after adjustment for age, estrogen use, or number of postoperative or postmenopausal years, notes Donna Kritz-Silverstein, Ph.D., of the University of California, San Diego.

Women currently using estrogen were significantly more likely to rate their life satisfaction as better than those who had never used estrogen. Even among women who had never used estrogen (which may improve mood and a sense of well-being), a significantly greater proportion of women who had a hysterectomy with ovarian conservation rated their life satisfaction as better than women who did not have a hysterectomy. Relief from symptoms (such as constant pain and heavy bleeding) necessitating hysterectomy may be responsible for the increased satisfaction among these women. Women who had a hysterectomy with both ovaries removed and had never used estrogen may have experienced new symptoms due to low levels of estrogen and testosterone.

See "Hysterectomy status and life satisfaction in older women," by Dr. Kritz-Silverstein, Deborah L. Wingard, Ph.D., and Elizabeth Barrett-Connor, M.D., in the Journal of Women's Health and Gender-Based Medicine 11(2), pp. 181-190, 2002.

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