The effect of hysterectomy on ovarian blood supply and endocrine function

Hu, Xiangying; Lili, Huang; Shi, Yuhua

doi:10.1080/13697130600865774

Cited by 54 publications

(44 citation statements)

References 25 publications

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“…The biologic mechanisms may relate to a combined effect of hormonal changes and the age at which the surgery occurs. Studies have shown that even with ovarian conservation, women with a hysterectomy experience changes in hormone levels and blood supply to the ovaries post-surgery [23,24] resulting in an early onset of symptoms (as evidenced in our study where hysterectomy was associated with a higher risk of early onset symptom patterns). It has been estimated that women who have a hysterectomy reach menopause around 1.9-3.7…”

Section: Discussionsupporting

confidence: 52%

Hot flushes and night sweats symptom profiles over a 17-year period in mid-aged women: The role of hysterectomy with ovarian conservation

et al. 2016

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flushes and night sweats symptom profiles over a 17-year period in mid-aged women: the role of hysterectomy with ovarian conservation.Maturitas http://dx.doi.org/10. 1016/j.maturitas.2016.05.011 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Highlights There has been limited longitudinal analysis of hysterectomy and vasomotor symptoms.  The present study found that hysterectomy with ovarian conservation is associated with persistent hot flushes and night sweats.  Obesity, smoking and a lower level of education/occupation are also associated with persistent symptoms.Hot flushes and night sweats symptom profiles over a 17-year period in mid-aged women: the role of hysterectomy with ovarian conservation. ABSTRACT OBJECTIVES:There is limited research on hot flushes and night sweats in women with a hysterectomy with ovarian conservation. We aimed to describe the patterns of these symptoms in a cohort of Australian women and to investigate the relationship between distinct symptom patterns and hysterectomy status. STUDY DESIGN AND OUTCOME MEASURES:Repeated-measures latent class analysis (LCA) was used to identify hot flushes and night sweats symptom patterns across seven surveys (over 17 years) in the mid-cohort of the Australian Longitudinal Study on Women"s Health. Multinomial logistic regression was used to assess the associations of the symptom patterns in women with a hysterectomy with ovarian conservation (n=1,129) versus women without a hysterectomy (n=4,977). RESULTS:A higher proportion of women with a hysterectomy than of those without experienced a constant pattern of hot flushes (15% versus 30%) and night sweats (9% versus 19%). Women with a hysterectomy had higher odds of constant hot flushes versus minimal hot flushes (OR = 1.97, 95% CI: 1.64, 2.35) and constant versus minimal night sweats (OR = 2.09, 95% CI: 1.70, 2.55). Smoking, a "lower level of education to non-professional occupation" pathway and body mass index (BMI) patterns of "always obese" and "increasingly obese" were also associated with a higher risk of constant symptoms. CONCLUSIONS:Women who have a hysterectomy (with ovarian conservation) have a higher risk of hot flushes and night sweats that persist over an extended period.

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Section: Discussionsupporting

confidence: 52%

Hot flushes and night sweats symptom profiles over a 17-year period in mid-aged women: The role of hysterectomy with ovarian conservation

et al. 2016

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“…This finding can be explained by at least 2 hypotheses (21–24): 1) hysterectomy disrupts ovarian blood flow or removes paracrine or endocrine signals from the uterus (or both), thereby hastening follicular depletion and leading to earlier menopause; 2) underlying diminished ovarian reserve in women presenting for hysterectomy causes symptoms (eg, menorrhagia, leiomyoma growth, etc) prompting hysterectomy. The present study argues against the latter hypothesis because we show that women presenting for hysterectomy had similar antimüllerian hormone levels as referent women at baseline.…”

Section: Discussionmentioning

confidence: 99%

Association of Ovary-Sparing Hysterectomy With Ovarian Reserve

Trabuco

Moorman

Algeciras‐Schimnich

et al. 2016

Obstetrics &Amp; Gynecology

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Objective To evaluate the association of hysterectomy on ovarian function by comparing antimüllerian hormone, a marker of ovarian reserve, before and after hysterectomy. Methods The Prospective Research on Ovarian Function study prospectively followed 1) premenopausal women undergoing ovary-sparing hysterectomy for benign indications and 2) a referent cohort with similar age distributions and intact reproductive organs; they reported that women undergoing hysterectomy became menopausal 1.9 years earlier than referents. In a planned secondary analysis, baseline antimüllerian hormone levels and the absolute change and percent change in antimüllerian hormone levels between baseline and 1-year follow-up were compared between groups. Results Baseline median antimüllerian hormone levels were similar between the hysterectomy group (n=148) and the referent group (n=172). After 1 year, hysterectomy patients had a significantly greater median percent decrease (−40.7% vs −20.9%; P<.001), had a higher proportion with undetectable antimüllerian hormone (12.8% vs 4.7%; P=.02), and had on average 0.77 times the antimüllerian hormone level (P=.001) compared with referents. These differences were attenuated among white women, but remained significant among black women. Comparisons of women stratified by low or high ovarian reserve at baseline or among propensity score–matched cohorts showed similar findings; however, the absolute median change in antimüllerian hormone levels was similar between groups (−0.3 vs −0.2; P=.31). Conclusion Women undergoing hysterectomy had similar antimüllerian hormone levels at baseline and experienced a greater percent decrease in levels after 1 year compared with referents, suggesting that hysterectomy may lead to ovarian damage that is unrelated to baseline ovarian reserve.

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“…In concurrence with the WHI trial we found that concomitant BSO at the time of hysterectomy does not incur additional risks of cancer . Previous studies linking hysterectomy to incident cancers have suggested that hysterectomy without BSO may interfere with ovarian blood supply and compromise ovarian function . Hysterectomy may result in increased levels of follicle‐stimulating hormone, lower estrogen and testosterone levels, and precipitate menopause as compared to women not having a hysterectomy .…”

Section: Discussionmentioning

confidence: 99%

Long‐term cancer risk after hysterectomy on benign indications: Population‐based cohort study

Altman

Yin

Falconer

2016

Intl Journal of Cancer

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Hysterectomy on benign indications is associated with an increased risk for adverse health effects. However, little is known about the association between hysterectomy and subsequent cancer occurrence later in life. The purpose of this study was to assess the effect of hysterectomy on the incidence of cancer. In this population-based cohort study, we used data on 111,595 hysterectomized and 537,9843 nonhysterectomized women from nationwide Swedish Health Care registers including the Inpatient Register, the Cancer Register and the Cause of Death Register between 1973 and 2009. Hysterectomy with or without concomitant bilateral salpingo-ophorectomy (BSO) performed on benign indications was considered as exposure and incidence of primary cancers was used as outcome measure. Rare primary cancers (<100 cases for the two groups combined) were excluded from analysis. A marginal risk reduction for any cancer was observed for women with previous hysterectomy and for those with hysterectomy and concurrent BSO (HR 0.93, 95% CI 0.91-0.95 and HR 0.92, 95% CI 0.87-0.96, respectively). Compared to nonhysterectomized women, significant risks were observed for thyroid cancer (HR 1.76, 95% CI 1.45-2.14). For both hysterectomy and hysterectomy with BSO, an association with brain cancer was observed (HR 1.48, 95% CI 1.32-1.65 and HR 1.45, 95% CI 1.15-1.83, respectively). Hysterectomy, with or without BSO, was not associated with breast, lung or gastrointestinal cancer. We conclude that hysterectomy on benign indications is associated with an increased risk for thyroid and brain cancer later in life. Further research efforts are needed to identify patient groups at risk of malignancy following hysterectomy.

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The effect of hysterectomy on ovarian blood supply and endocrine function

Abstract: Hysterectomy may impair ovarian blood supply and function. There is good correlation between Doppler parameters and endocrine parameters.

Cited by 54 publications

References 25 publications

Hot flushes and night sweats symptom profiles over a 17-year period in mid-aged women: The role of hysterectomy with ovarian conservation

Hot flushes and night sweats symptom profiles over a 17-year period in mid-aged women: The role of hysterectomy with ovarian conservation

Association of Ovary-Sparing Hysterectomy With Ovarian Reserve

Long‐term cancer risk after hysterectomy on benign indications: Population‐based cohort study

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