Hysterectomy and mental health status, findings from Ardakan Cohort Study on Aging (ACSA)

Abstract Background Many middle-aged and older women have undergone hysterectomy in their lifetime. The mental health outcomes of hysterectomy are controversial. This study aimed to evaluate depression and anxiety association with hysterectomy, with or without oophorectomy. Methods This cross-sectional study used data from the first phase of the Ardakan Cohort Study on Aging (ACSA). The population of this study included women aged ≥ 50 years recruited through multilevel stratified random sampling. Data on menopausal age, hysterectomy status, hormone replacement therapy, number of children, exercise frequency, financial situation, educational background, household conditions, occupational status, and stressful life events were collected. Mental health status was assessed using the Center for Epidemiologic Studies Short Depression Scale-10 (CESD-10) for depression and the Hospital Anxiety and Depression Scale (HADS) for anxiety. Statistical analysis, including linear and logistic regression, compared three groups: those with no hysterectomy, those with hysterectomy with oophorectomy, and those without oophorectomy. Results Among 2,252 menopausal women, 450 (19.9%) underwent hysterectomy with oophorectomy, and 101 (4.4%) underwent hysterectomy without oophorectomy. After accounting for all factors, no association was found between hysterectomy and mental health. Subsequent analysis among those with a history of hysterectomy revealed that individuals 10–15 years post-hysterectomy experienced a 56% reduction in depression compared to those less than 10 years post-hysterectomy (p-value = 0.043). However, this association was not observed for anxiety. Conclusions There was no association between hysterectomy, with or without oophorectomy, and depression or anxiety. Further research is warranted to explore the mental health outcomes associated with hysterectomy.