Hysterectomy and ovarian function: levels of follicle stimulating hormone and incidence of menopausal symptoms are not affected by hysterectomy in women under age 45 years

Objective To investigate levels of follicle stimulating hormone (FSH), as a measure of ovarian function and menopausal symptoms prior to and following hysterectomy in women under the age of 45 years. Design This was a prospective controlled study. Sample A total of 56 hysterectomy patients and 34 controls, up to the age of 42 years, were recruited. Methods Women undergoing hysterectomy were recruited prior to their operation and were matched, where possible, with controls for age, parity and smoking. Five blood samples were taken over 2 years, two before the operation (or at a 1-month interval in the control group) and then at 6 months, 1 year and 2 years. Questionnaires were completed at each sampling to assess symptoms associated with reduced estrogen secretion. Results No significant differences in FSH levels between patients and controls were found. Modest differences in FSH levels between different time-points were identified (p = 0.03), but this disappeared if age and smoking were included as covariates. For the questionnaire data, there were no significant differences between the two groups on the somatic and vasomotor scales, but for psychological symptoms the patients scored significantly higher than the controls (p = 0.007), particularly at the pre-operation time-point. Conclusion The study found no evidence of compromise of ovarian function, as reflected in FSH levels, within 2 years of hysterectomy. Psychological symptoms were higher in women undergoing hysterectomy both before and after the operation.