Hysterectomy status and life satisfaction in older women

This cross-sectional, population-based study examines the long-term effect of hysterectomy on life satisfaction in 1177 women aged 55-94 years.

A 1992 mailed survey obtained information on menopausal history, including hysterectomy and oophorectomy status, and estrogen use. Two standardized measures ascertained general life satisfaction: the Life Satisfaction Index-Z (LSI-Z) and the Satisfaction with Life Scale (SWLS). A separate question asked participants to rate life satisfaction (better, the same, or worse) after menopause or hysterectomy compared with before.

Twenty-three percent of the women reported hysterectomy with bilateral oophorectomy an average of 24 years earlier, and 26% reported hysterectomy with ovarian conservation an average of 28 years earlier. Women who were 20 or more years posthysterectomy or postmenopause were significantly more likely to rate their life satisfaction as better than were women 5 or fewer years posthysterectomy or postmenopause (p < 0.01). Among women with a hysterectomy, 53% with oophorectomy and 60% with ovarian conservation rated life satisfaction better after hysterectomy. Only 42.2% of women without a hysterectomy rated life satisfaction as better after menopause (p < 0.001). Differences persisted after adjustment for age and other covariates: p < 0.01 for hysterectomy with ovarian conservation and p < 0.001 for hysterectomy with bilateral oophorectomy vs. no hysterectomy. Even among women who had never used estrogen, a significantly greater proportion of those who had a hysterectomy with ovarian conservation rated their life satisfaction as better compared with women who did not have a hysterectomy (p < 0.05). There were no differences in standard life satisfaction scores (LSI-Z or SWLS) by hysterectomy status.

There are no long-term adverse effects of hysterectomy on life satisfaction. When queried specifically, women report increased life satisfaction following hysterectomy. Relief from symptoms necessitating hysterectomy may be responsible for this increase. This difference may be specific to hysterectomy because there were no differences in general life satisfaction as assessed with standardized measures.