Hysterectomy,Oophorectomy,and Depression in Older Women

Abstract

The purpose of this study was to examine the relation of hysterectomy, with and without oophorectomy, to depression in older women. This was a cross-sectional, population-based study of 1074 postmenopausal women, aged 50–89. The database included medical history, hysterectomy and oophorectomy status, and current estrogen use. The Beck Depression Inventory (BDI) score was used as a continuous measure of depressed mood and as a categorical variable, with those scoring ≥13 categorized considered as depressed. Of the women studied, 22.3% reported hysterectomy with ovarian conservation and 20.8% reported hysterectomy with bilateral oophorectomy. Current estrogen use was reported by 42.8% of oophorectomized women, 37.9% with hysterectomy and ovarian conservation, and 20.4% with natural menopause. The mean BDI score was 6.6, and 9.2% of subjects could be categorized as depressed. Hysterectomized women with ovarian conservation did not differ from naturally menopausal women in adjusted BDI scores, but women with oophorectomy had marginally higher scores (p = 0.06). Oophorectomized women also had a higher (p = 0.06) rate of categorical depression (12.7%) than women with natural menopause (8.7%) or hysterectomy and ovarian conservation (7.7%). Stratified analyses indicated significantly (p < 0.01) more depression for oophorectomized than for naturally menopausal women only among those 5 or fewer years postmenopause. Bilateral oophorectomy, but not hysterectomy, was associated with slightly increased depression scores. However, depressive symptoms were observed only in recently menopausal women and may be short-lived.