Hysterectomy linked to poorer physical functioning

Women who undergo a hysterectomy may have more problems with daily activities like climbing stairs and carrying groceries than women who go through a natural menopause, new research suggests.

In a study of 544 middle-aged women, researchers found that those who'd had a hysterectomy tended to develop more difficulties with a number of everyday physical activities.

This was true regardless of whether they were taking hormone replacement therapy, the researchers report in the journal Obstetrics & Gynecology.

A hysterectomy is the surgical removal of the uterus. It may be performed to treat cancer or certain other conditions, like endometriosis, fibroids or persistent vaginal bleeding.

Some research has suggested that menopause may speed the development of physical limitations in women, but it's not clear whether this is the case.

For the new study, researchers at the University of Michigan in Ann Arbor looked at whether physical functioning differed in women who'd had a hysterectomy and those who'd gone through menopause naturally.

They found that over the five-year study period, women who had a natural menopause and did not take hormone replacement therapy performed more poorly on physical functioning tests than women who had not yet gone through menopause.

Those who were on hormone replacement, however, performed nearly as well as premenopausal women.

In contrast, women who'd had a hysterectomy had more physical limitations than women who went through menopause naturally, regardless of whether they were taking hormonal therapy.

These women tended to do more poorly on tests of physical function, such as stair climbing and measures of hand-grip strength. They also reported more difficulties in day-to-day activities like walking, carrying groceries, bending and kneeling.

The findings raise the possibility that women who've had a hysterectomy will be more vulnerable to disabilities as they age, according to the researchers, led by Dr. MaryFran Sowers.

It's not clear why hysterectomy was linked to a greater risk of physical limitations. The surgery itself, the condition that precipitated it, or the sudden hormonal change that a hysterectomy causes could all play some role, Sowers and her colleagues speculate.

More studies, they conclude, are needed to see whether women who've had a hysterectomy are in fact at greater risk of disability and poorer quality of life as they grow older.

SOURCE: Obstetrics & Gynecology, December 2007.