Children's Health

After more than 20 years, quality of life is similar for women who had a hysterectomy or went through natural menopause

The first study to examine the long-term impact of hysterectomy on quality of life found no difference in quality of life between women who had a hysterectomy (with or without ovarian removal) an average of 27 years previously and women who had a natural menopause 25 years earlier. On the other hand, estrogen use was associated with lower quality of life in these women (average age of 73 years), who were unlikely to be using estrogen to treat hot flashes.

Women who were current estrogen users had lower health-related quality of life (HRQOL) scores and higher symptom scores than those who were former users or had never used estrogen, even after adjustment for age, type of menopause, and behavioral and lifestyle factors. This finding may reflect an adverse effect of hormone use on HRQOL in older postmenopausal women, suggests University of California, San Diego researcher, Donna Kritz-Silverstein, Ph.D.

In the study, which was supported in part by the Agency for Healthcare Research and Quality (HS06726), the researchers obtained information on menopausal history, including hysterectomy status, and history of estrogen use from a sample of 801 women aged 50-96 years during clinic visits between 1992 and 1996. A week after the visit, the women were contacted by phone and the quality of well-being (QWB) scale was administered.

Twenty-five percent of the women reported hysterectomy with both ovaries removed an average of 28 years earlier, and 11 percent had hysterectomy with ovarian conservation an average of 26.5 years earlier. Overall, 44 percent of the women reported current estrogen use, and 24 percent reported past use. Age-adjusted comparisons indicated that women with natural menopause had slightly higher QWB scores and lower symptom subscale scores than women in either of the hysterectomy groups. However, after additional adjustment for estrogen use and other potentially confounding factors, there was no significant difference in total QWB score or on any subscale score by hysterectomy status.

See "Hysterectomy status, estrogen use and quality of life in older women: The Rancho Bernardo study," by Dr. Kritz-Silverstein, Denise G. Von Muhlen, M.D., Ph.D., Theodore G. Ganiats, M.D., and Elizabeth Barrett-Connor, M.D., in Quality of Life Research 13, pp. 55-62, 2004.

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