Hysterectomy leads to earlier menopause

Menopause arrives nearly four years earlier on average for women who have had a hysterectomy compared with those who have not, a New Zealand study shows.

"These results should be discussed with premenopausal women considering hysterectomy," Dr. Cynthia M. Farquhar and colleagues write in the medical journal BJOG: an International Journal of Obstetrics and Gynecology.

Farquhar and University of Auckland-based associates prospectively studied 257 premenopausal women who had a hysterectomy and 259 matched women who did not.

During 5 years of follow-up, significantly more women in the hysterectomy group than in the comparison group reached menopause - 21 percent versus 7percent.

"The major finding in this study," the researchers point out, is that women who have undergone hysterectomy reached Menopause 3.7 years sooner than non-hysterectomized women, regardless of their weight or whether they smoked.

A total of 28 women in the hysterectomy group had also had an ovary removed, and 10 of them (36 percent) reached Menopause during the 5-year follow-up period. On average, these women reached menopause 4.4 years sooner than women who retained both ovaries after hysterectomy.

These findings, the team writes, are "sufficiently robust to raise concerns for women and gynecologists, especially given the widespread use of hysterectomy and concerns about long term use of estrogen replacement therapy."

SOURCE: BJOG: an International Journal of Obstetrics and Gynecology, July 2005.