Hysterectomy Helps Relieve Symptoms for Some Women
WebMD News Archive
March 14, 2000 (New York) -- Women who have a hysterectomy in Maryland for a
non-cancerous condition usually get relief from the symptoms that caused them
to seek the procedure, according to a new study in the March issue of the
journal Obstetrics & Gynecology. Hysterectomies for cancerous
conditions were not studied.
Kristen H. Kjerulff, MS, PhD, the study's lead author, says that the study
applies largely to women who have symptoms such as bleeding, bloating, and/or
pelvic pain -- symptoms that a hysterectomy has the potential to help address.
Kjerulff is associate professor of epidemiology and preventive medicine at the
University of Maryland School of Medicine in Baltimore.
But don't make that appointment with your ob/gyn just yet. Kjerulff tells
WebMD that this finding may not prove relevant in states where doctors overuse
hysterectomy. Maryland has one of the lowest hysterectomy rates in the U.S.
"Women do feel better [and] report substantial improvements by and large
that are maintained two years out," says Kjerulff. "We thought that
there might be a honeymoon period, but these benefits held up two years after
the surgery." However, she stopped short of saying the study recommends
performing hysterectomy for all women because there is wide variation in how
and when doctors perform hysterectomies. "I don't know if these results are
replicable in places where hysterectomies are more common," she says.
In the study, researchers followed for two years nearly 1,300 women who were
scheduled to have a hysterectomy for a non-cancerous condition at 28 hospitals
across Maryland. The authors assessed symptoms of vaginal bleeding, pelvic
pain, fatigue, back pain, abdominal bloating, sleep disturbance, urinary
incontinence, and activity limitation before surgery at different intervals
during the two years after surgery.
However, hysterectomy did not relieve symptoms for some women, most notably
those women with lower incomes, women in psychological therapy, and women with
children under age 18 living in their home. Speculating on why low-income women
might do worse, Kjerulff says that "they are often in very chaotic life
situations," with poverty being an enormous stress in their lives.
Based on her findings, Kjerulff says, "women who are clinically
depressed may not be good candidates for hysterectomy. Symptoms might be caused
by distress rather than gynecological problems." Yet the study showed that
approximately 25% of women evaluated before having a hysterectomy showed
evidence of clinical depression.
The study was not designed to determine whether the depression was long term
or just in anticipation of the surgery. And the authors did not look at whether
women were taking antidepressants. However, one variable that stood out was
that women in psychological therapy tended to report less symptom relief.
Another key finding is that women who had their ovaries removed during the
hysterectomy had worse outcomes two years later, a finding that Kjerulff says
"could not be explained."