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Vaginal Health

20 September 2019

Does having a hysterectomy put women at higher risk of developing depression and anxiety?

Before opting for a hysterectomy, women should be informed of several alternatives to managing benign gynaecological conditions, especially at a young age.

Having a hysterectomy can be a traumatic experience, and new research now shows it may also increase the long-term risk for depression and anxiety.

"Our study shows that removing the uterus may have more effect on physical and mental health than previously thought," said senior author Dr Shannon Laughlin-Tommaso, an ob-gyn at the Mayo Clinic in Rochester, Minnesota.

Several alternatives

"Because women often get a hysterectomy at a young age, knowing the risks associated with the procedure even years later is important," she said in a clinic news release.

She and her colleagues reviewed the health records of nearly 2 100 women who underwent removal of the uterus but not the ovaries. They found they had about a 7% increased risk of depression and a 5% increased risk of anxiety over 30 years.

Women who had a hysterectomy between the ages of 18 and 35 had the highest (12%) risk of depression, according to the study. It was recently published in the journal Menopause.

There are several alternatives to hysterectomy for women with benign gynaecological conditions, Laughlin-Tommaso noted.

"Those alternatives should be tried before going to hysterectomy, especially at a young age," she said.

More conservative strategies

A second Mayo study in the same journal found that 1 653 premenopausal women who had both ovaries removed at the time of hysterectomy without an indication of cancer were more likely to have pre-existing mood disorders, anxiety disorders or other mental health disorders.

Most of the women had their ovaries removed to prevent or minimise the risk of ovarian or breast cancer.

"We can say that psychological conditions may have played an important role in the decision to perform a hysterectomy, with or without removal of the ovaries," said study senior author Dr Walter Rocca, a neurologist and epidemiologist.

"Understanding the psychiatric conditions that may have influenced the past practice of hysterectomy is important for developing more conservative strategies in the future," he said.

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