Relation between hysterectomy and subsequent ovarian function in a district hospital population

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Abstract
Summary The proportion of women with ovarian failure at specific time intervals following a hysterectomy with conservation of ovarian tissue was determined. Five hundred and sixty-one women who had had an abdominal hysterectomy in the previous 6 years were invited to have their current ovarian function established. Of these, 405 entered the study and 50 per cent of them had ovarian failure; 142 were currently having hormone replacement and 62 were diagnosed biochemically. Women aged less than 42 years at the time of surgery were found to have a shorter duration of subsequent ovarian function than expected. Six per cent of women had required further ovarian surgery after the hysterectomy. Fifty per cent of women with vasomotor symptoms were not found to be biochemically menopausal and 36 per cent of those with a biochemically diagnosed menopause did not have vasomotor symptoms. Cigarette smoking and having a unilateral oophorectomy with the hysterectomy were found to decrease independently the duration of subsequent ovarian function. The practice of routinely conserving macroscopically normal ovaries in women aged over 40 years at the time of hysterectomy may not be justified. More information is obviously relevant than merely a woman's age at operation.