子宫切除不切除卵巢对绝经后妇女健康的影响：生理、心理和认知因素的评估

IF 3.6 2区医学 Q2 GERIATRICS & GERONTOLOGY

Maturitas Pub Date : 2025-02-28 DOI:10.1016/j.maturitas.2025.108229

Juan E. Blümel , Peter Chedraui , María S. Vallejo , Carlos Escalante , Gustavo Gómez-Tabares , Álvaro Monterrosa-Castro , Mónica Ñañez , Eliana Ojeda , Claudia Rey , Doris Rodríguez Vidal , Marcio A. Rodrigues , Carlos Salinas , Konstantinos Tserotasl , Andrés Calle , Maribel Dextre , Alejandra Elizalde , María T. Espinoza

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引用次数: 0

摘要

目的探讨不切除双侧卵巢的子宫切除术对绝经后妇女生理、心理和认知健康的影响。方法：本研究是一项横断面观察性研究的亚分析，该研究在九个拉丁美洲国家的妇科会诊期间进行。我们收集了社会人口学和临床资料，并使用EQ-5D评估健康状况，绝经期症状评定量表，6项女性性功能指数评估性功能，Jenkins睡眠量表评估睡眠障碍，SARC-F评估肌肉减少症风险，蒙特利尔认知功能评估测试评估认知功能。结果共纳入782名绝经后妇女，平均年龄56.9岁，平均体重指数26.5 kg/m2。参与者平均受教育年限为13.9年，其中45.9%的人拥有大学学位。104名接受子宫切除而不切除卵巢的女性体重指数更高(27.5±4.9 vs 26.3±5.1 kg/m2, p <；0.03)，显示出更多的合并症(63.5% vs 41.7%, p <；0.001)，自我感觉健康状况较差（优势比，OR 2.00, 95% CI: 1.27-3.15），严重绝经期症状（OR 2.39, 95% CI: 1.51-3.77）和睡眠障碍（OR 1.75, 95% CI: 1.10-2.79）的发生率高于未行子宫切除术的患者，肌肉减少症（OR 1.74, 95% CI: 1.03-2.97）的可能性更高。在性功能和认知能力方面，两组没有显著差异。此外，在六个评估的健康领域中，绝经期激素治疗（曾经使用过）被发现是一个保护因素，无论妇女是否接受过子宫切除术。结论行子宫切除而不切除卵巢的妇女可能出现持续的生理和心理症状，影响其心理健康和生活质量。绝经期激素治疗与改善健康状况有关。

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Impact of hysterectomy without oophorectomy on the health of postmenopausal women: Assessment of physical, psychological, and cognitive factors

Objective

To determine the impact of hysterectomy without bilateral oophorectomy on the physical, psychological, and cognitive health of postmenopausal women.

Methods

This study was a sub-analysis of a cross-sectional, observational study carried out during gynecological consultations in nine Latin American countries. We collected sociodemographic and clinical data and evaluated the women's health using the EQ-5D for health status, the Menopause Rating Scale for menopausal symptoms, the 6-item Female Sexual Function Index for sexual function, the Jenkins Sleep Scale for sleep disturbances, the SARC-F for the risk of sarcopenia, and the Montreal Cognitive Assessment test for cognitive function.

Results

The sub-analysis involved 782 postmenopausal women with an average age of 56.9 years and an average body mass index of 26.5 kg/m². The participants had an average of 13.9 years of education, and 45.9 % of them had a university degree. The group of 104 women who had undergone hysterectomy without oophorectomy had a higher body mass index (27.5 ± 4.9 vs 26.3 ± 5.1 kg/m², p < 0.03), displayed more comorbidities (63.5 % vs 41.7 %, p < 0.001), worse self-perceived health (Odds ratio, OR 2.00, 95 % CI: 1.27–3.15), higher rates of severe menopausal symptoms (OR 2.39, 95 % CI: 1.51–3.77) and sleep disturbances (OR 1.75, 95 % CI: 1.10–2.79), and a higher likelihood of sarcopenia (OR 1.74, 95 % CI: 1.03–2.97) than those who had not undergone hysterectomy. No significant differences were observed regarding sexual function or cognitive performance between the two groups. Moreover, in the six assessed health domains, menopausal hormone therapy (ever use) was found to be a protective factor, regardless of whether or not the woman had undergone a hysterectomy.

Conclusion

Women who undergo hysterectomy without oophorectomy may experience persistent physical and psychological symptoms that affect their mental health and quality of life. Menopausal hormone therapy is associated with improved health outcomes.

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来源期刊

Maturitas 医学-妇产科学

CiteScore

9.10

自引率

2.00%

发文量

142

审稿时长

40 days

期刊介绍： Maturitas is an international multidisciplinary peer reviewed scientific journal of midlife health and beyond publishing original research, reviews, consensus statements and guidelines, and mini-reviews. The journal provides a forum for all aspects of postreproductive health in both genders ranging from basic science to health and social care. Topic areas include:• Aging• Alternative and Complementary medicines• Arthritis and Bone Health• Cancer• Cardiovascular Health• Cognitive and Physical Functioning• Epidemiology, health and social care• Gynecology/ Reproductive Endocrinology• Nutrition/ Obesity Diabetes/ Metabolic Syndrome• Menopause, Ovarian Aging• Mental Health• Pharmacology• Sexuality• Quality of Life