Prevalence and Clustering of Menopausal Symptoms in Older Women by Hysterectomy and Oophorectomy Status

Abstract

This study examines the association of hysterectomy and oophorectomy with the prevalence and clustering of menopausal symptoms in a large population-based sample of older women. Subjects were 1121 women aged 50-89 from the Rancho Bernardo Study. Information on menopause, hysterectomy, oophorectomy, estrogen use, and other covariates was obtained in 1984-1987. A 1989 mailed survey obtained information on menopausal symptoms. In this sample, 22.1% reported hysterectomy with bilateral oophorectomy, and 25.3% reported hysterectomy with ovarian conservation. Mean time since hysterectomy was 26 (+/-12) years. Overall, 37% reported current estrogen use, and 40% reported past use. The duration of estrogen use was longer for women who had a hysterectomy (p < 0.001). Age-adjusted comparisons indicated that more women who had a hysterectomy, with or without bilateral oophorectomy, reported greater energy after menopause (p = 0.003 and p = 0.001, respectively), and more women with bilateral oophorectomy reported greater interest in sex (p = 0.007) and that life was getting better (p = 0.012) than women with natural menopause. Principal components factor analysis of the symptom data for all women yielded four factors: psychological, vasomotor, positive feelings, and self-image. Analyses performed within each group of women yielded similar factors and loadings. Adjusted comparisons of factor scores indicated that positive feelings were significantly higher in women who had a hysterectomy, with or without bilateral oophorectomy (p < 0.01) than in women with natural menopause. This difference was limited to current estrogen users. Vasomotor symptoms, psychological symptoms, and negative self-image did not differ by hysterectomy or oophorectomy status before or after stratification for estrogen use (p > 0.10). This study found after a hysterectomy, women are more likely to recall positive feelings about their menopause than women with natural menopause. Relief from symptoms leading to hysterectomy and use of replacement estrogen may be partly responsible. Results do not support the thesis that surgical menopause is associated with a sustained increased prevalence of vasomotor, psychological, or other symptoms.

A health survey of Beijing middle-aged registered nurses during menopause

“…Hot flashes and sweating are prevalent in European and American women [31]. It has been reported that 74% of menopausal women experience vasomotor symptoms [32]. There is even evidence that up to 88% of perimenopausal women had hot flashes [33,34] [30].…”

Hot flushes and night sweats symptom profiles over a 17-year period in mid-aged women: The role of hysterectomy with ovarian conservation

“…Women who have a hysterectomy with bilateral oophorectomy (both ovaries removed) are consistently reported to have a higher risk of more frequent and/or severe hot flushes and night sweats, which is thought to be related to the abrupt decline in oestrogen levels post-surgery [5]. For women who have a hysterectomy with ovarian conservation (one or both ovaries retained) the reported associations are less consistent [6][7][8]. The proportion of women who retain one or both ovaries at the time of hysterectomy varies by country, ranging from 46% to 82% [4], highlighting the need to increase our understanding of the symptom experiences of these women.…”

Fatores associados à intensidade das ondas de calor em mulheres em climatério

“…Oldenhave et al 2 mostraram que mulheres com antecedente de histerectomia referiram sintomas climatéricos mais intensos que aquelas não histerectomizadas. É importante salientar que nem todos os estudos observaram relação entre histerectomia e ocorrência e intensidade das ondas de calor 11,4 .…”