Impact of hysterectomy without oophorectomy on the health of postmenopausal women: Assessment of physical, psychological, and cognitive factors

Abstract

Objective: To determine the impact of hysterectomy without bilateral oophorectomy on the physical, psychological, and cognitive health of postmenopausal women.

Methods: This study was a sub-analysis of a cross-sectional, observational study carried out during gynecological consultations in nine Latin American countries. We collected sociodemographic and clinical data and evaluated the women's health using the EQ-5D for health status, the Menopause Rating Scale for menopausal symptoms, the 6-item Female Sexual Function Index for sexual function, the Jenkins Sleep Scale for sleep disturbances, the SARC-F for the risk of sarcopenia, and the Montreal Cognitive Assessment test for cognitive function.

Results: The sub-analysis involved 782 postmenopausal women with an average age of 56.9 years and an average body mass index of 26.5 kg/m². The participants had an average of 13.9 years of education, and 45.9 % of them had a university degree. The group of 104 women who had undergone hysterectomy without oophorectomy had a higher body mass index (27.5 ± 4.9 vs 26.3 ± 5.1 kg/m², p < 0.03), displayed more comorbidities (63.5 % vs 41.7 %, p < 0.001), worse self-perceived health (Odds ratio, OR 2.00, 95 % CI: 1.27-3.15), higher rates of severe menopausal symptoms (OR 2.39, 95 % CI: 1.51-3.77) and sleep disturbances (OR 1.75, 95 % CI: 1.10-2.79), and a higher likelihood of sarcopenia (OR 1.74, 95 % CI: 1.03-2.97) than those who had not undergone hysterectomy. No significant differences were observed regarding sexual function or cognitive performance between the two groups. Moreover, in the six assessed health domains, menopausal hormone therapy (ever use) was found to be a protective factor, regardless of whether or not the woman had undergone a hysterectomy.

Conclusion: Women who undergo hysterectomy without oophorectomy may experience persistent physical and psychological symptoms that affect their mental health and quality of life. Menopausal hormone therapy is associated with improved health outcomes.

Keywords: Health; Hysterectomy; Menopausal hormone therapy; Oophorectomy; Quality of life.