The association of hysterectomy and menopause: a prospective cohort study
The association of hysterectomy and menopause: a prospective cohort study
复制标题
DOI：
10.1111/j.1471-0528.2005.00696.x
复制
发表时间：
2005-07-01
影响因子：
5.8
通讯作者：
Stewart, AW
中科院分区：
文献类型：
--
作者：
Farquhar, CM;Sadler, L;Stewart, AW
目的探讨子宫切除术是否会导致绝经期提前。设计一项前瞻性队列研究。背景：大型城市医院妇科服务。人群：绝经前妇女行子宫切除术和未行子宫切除术。方法采用多变量生存分析技术调整初始促卵泡激素（FSH）水平、体重指数、主要结果测量子宫切除术后5年的FSH水平，并与对照组进行比较。绝经定义为一个单一的FSH测量至少40 IU/L。结果257例接受子宫切除术的妇女与259例未接受子宫切除术的妇女进行了比较。在研究的五年中，子宫切除术组有53名妇女（20.6%）达到绝经期，对照组有19名妇女（7.3%）达到绝经期。术前FSH < 10 IU/L的子宫切除术组女性绝经时间比对照组女性早3.7年（95% CI 1.5-6.0年），与BMI、吸烟和单侧卵巢切除无关。子宫切除术组中有28名妇女接受了单侧卵巢切除术，其中10名（35.7%）在5年的随访中达到绝经。单侧卵巢切除子宫切除术组的女性绝经时间比双侧卵巢切除子宫切除术组的女性早4.4年（95%CI 0.6，7.9年），与基线FSH、BMI和吸烟无关。在这项研究中，子宫切除术和单侧卵巢切除术与绝经期的更早发生有关。
Objective To determine whether or not hysterectomy leads to an earlier onset of the menopause.Design A prospective cohort study.Setting Gynaecology service of large urban hospital.Population Premenopausal women with and without hysterectomy.Methods Multivariate survival analysis techniques were used to adjust for differences in initial follicle stimulating hormone (FSH) levels, body mass index, smoking and unilateral oophorectomy between the groups.Main outcome measures FSH levels were measured for five years following hysterectomy and compared with the comparison group. Menopause was defined as a single FSH measurement of at least 40 IU/L.Results Two hundred and fifty-seven women undergoing hysterectomy were compared with 259 women who had not undergone a hysterectomy. Fifty-three women (20.6%) in the hysterectomy group and 19 women (7.3%) in the comparison group reached menopause over the five years of the study. Women in the hysterectomy group with a pre-operative FSH < 10 IU/L reached menopause 3.7 years (95% CI 1.5-6.0 years) earlier than women in the comparison group independent of BMI, smoking and unilateral oophorectomy. Twenty-eight women in the hysterectomy group had unilateral oophorectomy and 10 (35.7%) of these women reached menopause over the five years of follow up. Women in the hysterectomy group with unilateral oophorectomy reached menopause 4.4 years (95% CI 0.6, 7.9 years) earlier than women with both ovaries in the hysterectomy group independent of baseline FSH, BMI and smoking.Conclusions Hysterectomy is associated with an earlier onset of menopause. Hysterectomy with unilateral oophorectomy is associated with an even earlier onset of the menopause in this study.