Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15213, USA.
Obstet Gynecol. 2012 May;119(5):935-41. doi: 10.1097/AOG.0b013e31824f9c14.
To examine whether mood symptoms increased more for women in the years after hysterectomy with or without bilateral oophorectomy relative to natural menopause.
Using data from the Study of Women's Health Across the Nation (n=1,970), depression and anxiety symptoms were assessed annually for up to 10 years with the Center for Epidemiological Studies Depression Index and four anxiety questions, respectively. Piece-wise hierarchical growth models were used to relate natural menopause, hysterectomy with ovarian conservation, and hysterectomy with bilateral oophorectomy to trajectories of mood symptoms before and after the final menstrual period or surgery. Covariates included educational attainment, race, menopausal status, age the year before final menstrual period or surgery, and time-varying body mass index, self-rated health, hormone therapy, and antidepressant use.
By the tenth annual visit, 1,793 (90.9%) women reached natural menopause, 76 (3.9%) reported hysterectomy with ovarian conservation, and 101 (5.2%) reported hysterectomy with bilateral oophorectomy. For all women, depressive and anxiety symptoms decreased in the years after final menstrual period or surgery. These trajectories did not significantly differ by hysterectomy or oophorectomy status. The Center for Epidemiological Studies Depression Index means were 0.72 standard deviations lower and anxiety symptoms were 0.67 standard deviations lower 5 years after final menstrual period or surgery.
In this study, mood symptoms continued to improve after the final menstrual period or hysterectomy for all women. Women who undergo a hysterectomy with or without bilateral oophorectomy in midlife do not experience more negative mood symptoms in the years after surgery.
II.
研究与自然绝经相比，子宫切除术伴或不伴双侧卵巢切除术的女性在绝经后几年中情绪症状是否会增加更多。
利用全国妇女健康研究（n=1970）的数据，使用流行病学研究抑郁指数和四个焦虑问题分别每年评估一次抑郁和焦虑症状，最长可达 10 年。分段分层增长模型用于将自然绝经、保留卵巢的子宫切除术和双侧卵巢切除术与绝经前或手术后最后一次月经的情绪症状轨迹相关联。协变量包括教育程度、种族、绝经状态、最后一次月经或手术前一年的年龄以及随时间变化的体重指数、自我报告的健康状况、激素治疗和抗抑郁药的使用。
在第十次年度访问时，1793 名（90.9%）女性达到自然绝经，76 名（3.9%）报告行保留卵巢的子宫切除术，101 名（5.2%）报告行双侧卵巢切除术。对于所有女性，绝经后几年中抑郁和焦虑症状均有所减轻。这些轨迹与子宫切除术或卵巢切除术状态无显著差异。在最后一次月经或手术后 5 年，流行病学研究抑郁指数的平均值降低了 0.72 个标准差，焦虑症状降低了 0.67 个标准差。
在这项研究中，所有女性在最后一次月经或子宫切除术后，情绪症状继续改善。中年行子宫切除术伴或不伴双侧卵巢切除术的女性在手术后几年中不会经历更多的负面情绪症状。
II。
