Racial differences in women who have a hysterectomy for benign conditions.
OBJECTIVE
To evaluate if there are racial differences between African-American and Caucasian women who have hysterectomy for benign conditions in terms of (1) presenting symptoms (prolapse, vaginal bleeding, pain, and known history of leiomyomas), (2) serum estradiol and testosterone levels at the visit before hysterectomy, and (3) uterine weight.


METHODS
A multi-ethnic, multisite, community-based longitudinal cohort study of 3,302 women ages 42-52 at enrollment was conducted. During 9 years of follow-up, 203 African-American and Caucasian women reported a hysterectomy, 90 with evidence of uterine leiomyomas. Women were surveyed regarding their overall perceived health before and after hysterectomy, presenting symptoms, and their motivations for surgery. Serum estradiol and testosterone levels were measured. Uterine weight at time of hysterectomy and clinical pathology were determined via medical record abstraction.


RESULTS
Previously diagnosed leiomyomas were presenting symptoms more frequently in African-American women than Caucasian women (85% vs. 63%; p = .02). African-American women had less prolapse than Caucasian women (0% vs. 10%; p = 0.04). Chronic pain was a more frequent reason for hysterectomy in African-American women than in Caucasian women (49% vs. 29%; p = .05). There were no differences between the groups in levels of estradiol or testosterone. African-American women had almost twice the uterine weight as that of Caucasian women (448 vs. 240 g; p = .0005).


CONCLUSIONS
Racial differences in frequency of hysterectomy for benign conditions are consistent with differences in presenting symptoms, where African-American women seemingly have larger, more symptomatic fibroids.
Weiss
Gerson
G
New Jersey Medical School, UMDNJ, Newark, New Jersey.
Noorhasan
Dorette
D
Schott
Laura L
LL
Powell
Lynda
L
Randolph
John F
JF
Johnston
Janet M
JM
D001741:Black or African American; D015331:Cohort Studies; D004958:Estradiol / Q000097:blood; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data*; D007889:Leiomyoma / Q000208:ethnology* / Q000601:surgery; D016015:Logistic Models; D008137:Longitudinal Studies; D008875:Middle Aged; D009929:Organ Size; D010146:Pain / Q000208:ethnology; D013739:Testosterone / Q000097:blood; D014594:Uterine Neoplasms / Q000208:ethnology* / Q000601:surgery; D014596:Uterine Prolapse / Q000208:ethnology; D014599:Uterus / Q000473:pathology*; D044465:White People
D013739:Testosterone; D004958:Estradiol