Summary
Gibson CJ, Joffe H, Bromberger JT, et al. Mood symptoms after natural menopause and hysterectomy with and without bilateral oophorectomy among women in midlife. Obstet Gynecol 2012;119:935-941. Level of evidence: II-2.
The extent to which some midlife women might be vulnerable to developing mood or anxiety symptoms has been a point of debate in the literature. The potential association between mood symptoms and hysterectomy has been one of these controversial points. Although some have suggested that mood might deteriorate following the surgical procedure (with or without oophorectomy), most observations were cross-sectional or very brief in nature and failed to provide any assessment on psychological symptoms during the years preceding the surgery.
In this study, Gibson and colleagues utilized data prospectively collected in the Study of Women Across the Nation (SWAN) over 10 years to examine the course of mood and anxiety symptoms in an ethnically diverse cohort of midlife women (n = 1,970). The study included annual assessments both prior to and following menopause (natural, hysterectomy with ovarian conservation, or hysterectomy with bilateral oophorectomy). A 20-item depression symptom scale was applied to assess mood symptoms, whereas anxiety was assessed at each annual visit with four questions asking about irritability, tension, heart racing, and fearfulness. Most women (90.9%) reached natural menopause within the follow-up period, whereas 3.9% had a hysterectomy with ovarian conservation, and 5.2% reported hysterectomy with bilateral oophorectomy. The authors reported a decline in depressive and anxiety symptoms in the years after natural menopause or surgery; in addition, ovarian conservation or oophorectomy did not seem to have a significant impact on risk of these symptoms.