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The online version of this article (https://doi.org/10.1007/s11136-018-1812-9) contains supplementary material, which is available to authorized users.
Hysterectomy is one of the most common gynaecological procedures worldwide. Changes in endocrine function may impact age-associated decline in physical function and these changes may be accelerated by hysterectomy. The aim of this study was to investigate associations between hysterectomy status and self-reported physical function limitations.
Our study sample (n = 8624) came from the mid-cohort (born 1945–1950) of the Australian Longitudinal Study on Women’s Health (ALSWH). Self-report of physical function was measured by the Physical Functioning (PF) subscale of the Medical Outcomes Study Short Form Health Survey (SF-36) over seven surveys (1998–2016), categorised into substantial, moderate and minimal PF-limitations. The associations between hysterectomy status and de novo substantial or moderate PF-limitations versus minimal PF-limitations were investigated using log-multinomial regression.
By Survey 8 (2016), 20% of the study sample had a hysterectomy with ovarian conservation (hysterectomy only) and 9% had a hysterectomy and both ovaries removed (hysterectomy-bilateral oophorectomy). Women with a hysterectomy only had a small increase in risk of substantial PF-limitations (versus minimal PF-limitations) compared to women with no hysterectomy (relative risk [RR]: 1.13; 95% confidence interval [95% CI] 1.00–1.27); the point estimate was stronger for women with a hysterectomy-bilateral oophorectomy (RR: 1.26; 95% CI 1.09–1.46). In a supplementary analysis, the increased risk of substantial PF-limitations was seen only in women who had surgery before the age of 45 years.
Compared to women with no hysterectomy, women with hysterectomy-bilateral oophorectomy were at increased risk of substantial PF-limitations versus minimal PF-limitations over 18 years of follow-up.
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- Hysterectomy and perceived physical function in middle-aged Australian women: a 20-year population-based prospective cohort study
Louise F. Wilson
Gita D. Mishra
- Springer International Publishing