Winner of the Young Clinical investigater Manuscript Award: Hysterectomy Status and Preventive Health Behaviors in Older Women

Abstract

Objective: Approximately one-third of U.S. women have a hysterectomy by age 60. This study examines the association of hysterectomy status with preventive health behaviors in older women. Design: Cross-sectional, population-based. Setting: Rancho Bernardo, California; 1984–1987 clinic visit; 1989 mailed survey. Participants: 962 women from the Rancho Bernardo Study, aged 50–89. DataBase: Menopausal history, hysterectomy status, medical history, and marital status were ascertained; current estrogen use validated; blood pressure and cholesterol measured; and an oral glucose tolerance test administered during a 1984–1987 clinic visit. Main outcome measures: Preventive health behaviors ascertained by mailed survey in 1989 include changing fat and salt consumption, changing exercise, and other diet and lifestyle changes since 1975; and performance in previous year of preventive behaviors requiring a physician visit (i.e., cholesterol and blood pressure checks, and mammogram). Results: 47.2% of these women reported a hysterectomy. After adjustment for age, estrogen use, years postmenopausal, marital status, and presence of chronic diseases, hysterectomized women were significantly more likely than naturally menopausal women to have decreased dietary fat, and to have made other diet and lifestyle changes since 1975. The proportion visiting a physician during the previous year and performing other behaviors did not differ by hysterectomy status. Conclusions: Compared to naturally menopausal women, hysterectomized women are more likely to engage in preventive health behaviors that involve taking an active role and that are sustained over time.