Article

The association of hysterectomy and menopause: A prospective cohort study

Department of Obstetrics and Gynecology, National Women's Hospital, University of Auckland, New Zealand.
BJOG An International Journal of Obstetrics & Gynaecology (Impact Factor: 3.45). 07/2005; 112(7):956-62. DOI: 10.1111/j.1471-0528.2005.00696.x
Source: PubMed

ABSTRACT

To determine whether or not hysterectomy leads to an earlier onset of the menopause.
A prospective cohort study.
Gynaecology service of large urban hospital.
Premenopausal women with and without hysterectomy.
Multivariate survival analysis techniques were used to adjust for differences in initial follicle stimulating hormone (FSH) levels, body mass index, smoking and unilateral oophorectomy between the groups.
FSH levels were measured for five years following hysterectomy and compared with the comparison group. Menopause was defined as a single FSH measurement of at least 40 IU/L.
Two hundred and fifty-seven women undergoing hysterectomy were compared with 259 women who had not undergone a hysterectomy. Fifty-three women (20.6%) in the hysterectomy group and 19 women (7.3%) in the comparison group reached menopause over the five years of the study. Women in the hysterectomy group with a pre-operative FSH <10 IU/L reached menopause 3.7 years (95% CI 1.5-6.0 years) earlier than women in the comparison group independent of BMI, smoking and unilateral oophorectomy. Twenty-eight women in the hysterectomy group had unilateral oophorectomy and 10 (35.7%) of these women reached menopause over the five years of follow up. Women in the hysterectomy group with unilateral oophorectomy reached menopause 4.4 years (95% CI 0.6, 7.9 years) earlier than women with both ovaries in the hysterectomy group independent of baseline FSH, BMI and smoking.
Hysterectomy is associated with an earlier onset of menopause. Hysterectomy with unilateral oophorectomy is associated with an even earlier onset of the menopause in this study.

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Available from: Lynn Sadler, Nov 19, 2014
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    • "The effect of hysterectomy & oophorectomy upon the hormonal profile was also reported by, Moorman PG. et al. who, in agreement with our results, concluded that women undergoing hysterectomy were at significantly increased risk for ovarian failure notably those having a unilateral oophorectomy along with hysterectomy [16]. Farquhar et al. reported similar conclusions to those of this study [17]. A recent study by Hasan Toyganözü et al. reported changes in the ovarian environment after excision of the rudimentary horn in female Wistar albino rats. "
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    ABSTRACT: Objective: To compare induced surgical menopause in rat models following hysterectomy with ovarian preservation, unilateral or bilateral oophorectomy, versus control. Secondary objective was evaluation of certain physiological changes in the animal following the induced menopause. Design: A prospective case control study. Setting: University Research Centre. Methodology: 80 female rats were divided into four groups (n=20). HG: hysterectomy with ovarian preservation, UOG: unilateral oophorectomy, BOG: bilateral oophorectomy and CG: control rats. Blood tests were done at day 0, one week and one month post-procedure for hormonal profile including FSH and E2, and lipid profile including cholesterol, LDL and HDL. Behavioral tests (Learning and memory tests) were also done. Results: Menopause was successfully induced by the three used surgical methods. After one week, no significant difference in FSH level between CG and HG. But its level was significantly increased in BOG and UOG. E2 level was significantly decreased in HG, UOG and BOG in comparison to CG. Its level in BOG was significantly lower than that of UOG and HG. Cholesterol level was significantly higher in HG, UOG and BOG in comparison to CG, also its level was significantly increased in UOG and BOG in comparison to HG (P<0.001). Long term memory was affected in BOG and UOG, one week and one month post-menopausal induction in comparison to the control. Conclusion: surgical menopause, induced by hysterectomy alone, unilateral, or bilateral oophorectomy has a negative impact on reproductive hormonal function, as well as cognitive & cardiovascular integrity. We suggest a possibility of early ovarian failure after hysterectomy alone or with unilateral oophorectomy.
    Full-text · Article · Aug 2015 · International Journal of Clinical and Experimental Medicine
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    • "The effect of hysterectomy & oophorectomy upon the hormonal profile was also reported by, Moorman PG. et al. who, in agreement with our results, concluded that women undergoing hysterectomy were at significantly increased risk for ovarian failure notably those having a unilateral oophorectomy along with hysterectomy [16]. Farquhar et al. reported similar conclusions to those of this study [17]. A recent study by Hasan Toyganözü et al. reported changes in the ovarian environment after excision of the rudimentary horn in female Wistar albino rats. "

    Full-text · Article · Jun 2015 · International Journal of Clinical and Experimental Medicine
    • "Information on hysterectomy and oophorectomy status was also obtained through self-administered questionnaires. We considered women surgically post-menopausal if they had had a hysterectomy and/or uni-or bilateral oophorectomy before reaching natural menopause (Cooper and Thorp, 1999; Hardy and Kuh, 1999; Farquhar et al., 2005; Yasui et al., 2012). Women with missing or incomplete questionnaire data on menstruation status were classified as premenopausal when they were younger than 46 years, as perimenopausal when they were between 46 and 55 years of age, and as post-menopausal when they were older than 55 years at enrollment in which case they were excluded from the present analysis because of lack of information on age at menopause. "
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    ABSTRACT: STUDY QUESTION Do women who have diabetes before menopause have their menopause at an earlier age compared with women without diabetes? SUMMARY ANSWER Although there was no overall association between diabetes and age at menopause, our study suggests that early-onset diabetes may accelerate menopause. WHAT IS KNOWN ALREADY Today, more women of childbearing age are being diagnosed with diabetes, but little is known about the impact of diabetes on reproductive health. STUDY DESIGN, SIZE, DURATION We investigated the impact of diabetes on age at natural menopause (ANM) in 258 898 women from the European Prospective Investigation into Cancer and Nutrition (EPIC), enrolled between 1992 and 2000. PARTICIPANTS/MATERIALS, SETTING, METHODS Determinant and outcome information was obtained through questionnaires. Time-dependent Cox regression analyses were used to estimate the associations of diabetes and age at diabetes diagnosis with ANM, stratified by center and adjusted for age, smoking, reproductive and diabetes risk factors and with age from birth to menopause or censoring as the underlying time scale. MAIN RESULTS AND THE ROLE OF CHANCE Overall, no association between diabetes and ANM was found (hazard ratio (HR) = 0.94; 95% confidence interval (CI) 0.89–1.01). However, women with diabetes before the age of 20 years had an earlier menopause (10–20 years: HR = 1.43; 95% CI 1.02–2.01
    No preview · Article · Mar 2015 · Human Reproduction
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