Hysterectomy and subsequent psychological health: findings from a British birth cohort study.
BACKGROUND
The association between hysterectomy and subsequent, long-term psychological health is still not well characterised. We aimed to test the association between hysterectomy and subsequent psychological health and examine variation in this association by characteristics of hysterectomy.


METHODS
Using data on women in the MRC National Survey of Health and Development, followed up since birth in 1946 until age 53 years (N=1790) the associations between hysterectomy and General Health Questionnaire (GHQ)-28 scores were tested.


RESULTS
There was no clear association between hysterectomy status and GHQ-28 score at age 53 years when grouping all hysterectomies together. However, this masked significant variation in association by characteristics of hysterectomy. In unadjusted analyses women who had undergone hysterectomy for cancer had mean GHQ-28 scores at age 53 years which were 49.0% higher (95% CI: 3.4%, 94.7%) than women who had not undergone hysterectomy. In analyses adjusted for prior psychological state and vulnerability, lifetime socioeconomic position, weight at age 26 years, smoking status and hormone replacement therapy use, women who had undergone hysterectomy before age 40 years had GHQ-28 scores 29.5% higher (95% CI: 2.7%, 56.3%) than women who had not undergone hysterectomy.


CONCLUSIONS
Our findings suggest that women who undergo hysterectomy at a young age are a defined group who may require more support than other women to maintain good psychological health in middle-age.
MRC Unit for Lifelong Health and Ageing, 33 Bedford Place, London, WC1B 5JU, UK. r.cooper@nshd.mrc.ac.uk
Rachel
R
Cooper
Gita
G
Mishra
Rebecca
R
Hardy
Diana
D
Kuh
D000328:Adult; D000367:Age Factors; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000523:psychology*; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology*; D008875:Middle Aged; D010052:Ovariectomy / Q000523:psychology; D010555:Personality Inventory / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology* / Q000523:psychology*; D011446:Prospective Studies; D011594:Psychometrics; D006113:United Kingdom; D014594:Uterine Neoplasms / Q000523:psychology / Q000601:surgery