Aims.: There is limited longitudinal research that has looked at the longer term incidence of depressive symptoms, comparing women with a hysterectomy to women without a hysterectomy. We aimed to investigate the association between hysterectomy status and the 12-year incidence of depressive symptoms in a mid-aged cohort of Australian women, and whether these relationships were modified by use of exogenous hormones. Methods.: We used generalised estimating equation models for binary outcome data to assess the associations of the incidence of depressive symptoms (measured by the 10-item Centre for Epidemiologic Studies Depression Scale) across five surveys over a 12-year period, in women with a hysterectomy with ovarian conservation, or a hysterectomy with bilateral oophorectomy compared with women without a hysterectomy. We further stratified women with hysterectomy by their current use of menopausal hormone therapy (MHT). Women who reported prior treatment for depression were excluded from the analysis. Results.: Compared with women without a hysterectomy (n = 4002), both women with a hysterectomy with ovarian conservation (n = 884) and women with a hysterectomy and bilateral oophorectomy (n = 450) had a higher risk of depressive symptoms (relative risk (RR) 1.20; 95% confidence interval (CI) 1.06–1.36 and RR 1.44; 95% CI 1.22–1.68, respectively). There were differences in the strength of the risk for women with a hysterectomy with ovarian conservation, compared with those without, when we stratified by current MHT use. Compared with women without a hysterectomy who did not use MHT, women with a hysterectomy with ovarian conservation who were also MHT users had a higher risk of depressive symptoms (RR 1.57; 95% CI 1.31–1.88) than women with a hysterectomy with ovarian conservation but did not use MHT (RR 1.17; 95% CI 1.02–1.35). For women with a hysterectomy and bilateral oophorectomy, MHT use did not attenuate the risk. We could not rule out, however, that the higher risk seen among MHT users may be due to confounding by indication, i.e. MHT was prescribed to treat depressive symptoms, but their depressive symptoms persisted. Conclusions.: Women with a hysterectomy (with and without bilateral oophorectomy) have a higher risk of new incidence of depressive symptoms in the longer term that was not explained by lifestyle or socio-economic factors.

/pdf/hysterectomy-and-incidence-of-depressive-symptoms-in-midlife-yyj53jgv2o.pdf

Hysterectomy and incidence of depressive symptoms in midlife women: the Australian Longitudinal Study on Women's Health

Personal and professional use of menopausal hormone therapy among gynecologists: A multinational study (REDLINC VII)

Objectives: This study was undertaken to determine the impact of menopause on middle-eastern women.Methods: This was a cross-sectional study of 1520 women, aged 40–64 years, living in Sari, Norther...

Bothersome menopausal symptoms amongst postmenopausal Iranian women.

For 15 years, the Collaborative Group for Research of the Climacteric in Latin America (REDLINC) has been conducting research on several topics including age of menopause, metabolic syndrome, quality of life and climacteric symptoms, sexual dysfunction, poor quality of sleep and insomnia, and use of menopausal hormone therapy (MHT) in the general population and among gynecologists. Examples of data to have emerged for this region include the age of menopause (49 years), a high prevalence of metabolic syndrome (42.9%), and a new waist circumference cut-off value for the Latin American population (88 cm). Sexual dysfunction, poor quality of life, and sleep disorders have a prevalence of over 50%, with obesity and sedentary lifestyles affected importantly. MHT use is still low (12.5%), lack of prescription the most important reason for not using it, and gynecologists use MHT for themselves but do not recommend it often to their patients. The prevalence of alternative therapy use, recommended by physi...

Menopause research in Latin America.

Menopause in Latin America: Symptoms, attitudes, treatments and future directions in Costa Rica.

Background Menopausal hormone therapy (HT) has shown benefits for women; however, associated drawbacks (i.e. risks, costs, fears) have currently determined its low use.Objective To determine the prevalence of current HT use among mid-aged women and describe the characteristics of those who have never used, have abandoned or are currently using HT. In addition, reasons for not using HT were analyzed.Method This was a cross-sectional study that analyzed a total of 6731 otherwise healthy women (45–59 years old) of 15 cities in 11 Latin American countries. Participants were requested to fill out the Menopause Rating Scale (MRS) and a questionnaire containing sociodemographic data and items regarding the menopause and HT use.Results The prevalence of current HT use was 12.5%. Oral HT (43.7%) was the most frequently used type of HT, followed by transdermal types (17.7%). The main factors related to the current use of HT included: positive perceptions regarding HT (odds ratio (OR) 11.53, 95% confidence i...

A multicentric study regarding the use of hormone therapy during female mid-age (REDLINC VI)

Objective: To evaluate whether menopausal status and symptoms among female gynecologists would influence their clinical behavior related to menopausal hormone therapy (MHT).Methods: Female gynecologists of 11 Latin American countries were requested to fill out the Menopause Rating Scale and a questionnaire containing personal information and that related to MHT use.Results: A total of 818 gynecologists accepted to participate (86.4%). Overall, the mean age was 45.0 ± 10.7 years, 32.2% were postmenopausal, and 17.6% worked in an academic position; 81.8% reported that they would use MHT if they have symptoms, regardless of menopausal status. Academic gynecologists favor personal MHT use at a higher rate (p = 0.04) and have a higher MHT prescription rate as compared to non-academic ones (p = 0.0001). The same trend was observed among post- as compared to premenopausal ones (p = 0.01) and among those who had hysterectomy alone as compared to those experiencing natural menopause (p = 0.002). The presen...

Does the menopausal status of female gynecologists affect their prescription of menopausal hormone therapy

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A multicentric study regarding the use of hormone therapy during female mid-age (REDLINC VI)

Does the menopausal status of female gynecologists affect their prescription of menopausal hormone therapy