Dr Md Shariful Islam1, Dr Karen M. Tuesley1, Dr Louise F. Wilson1, Prof Susan J. Jordan1
1School of Public Health, The University of Queensland, Herston, Australia
Biography:
Md Shariful Islam is a medical doctor. He is currently pursuing a PhD at the School of Public Health, The University of Queensland. His doctoral research investigates the causal association between hysterectomy and osteoporosis using Australian linked administrative health data. Prior to his PhD, he worked as a researcher at icddr, b, Bangladesh.
Aims:
This study examined whether hysterectomy with bilateral oophorectomy (HBO) or unilateral oophorectomy (HUO) was associated with osteoporosis and fracture risk compared with hysterectomy alone, and whether associations varied by age at hysterectomy or hormone therapy use.
Methods:
We conducted a cohort study using linked administrative health data from all women residing in New South Wales and Victoria, Australia, who underwent hysterectomy for benign indications between 2004 and 2008. Exposure groups were HBO, HUO, and hysterectomy alone. Outcomes were osteoporosis and fracture.
Results:
Of 49,439 women followed for a median of 15.1 years. HBO was associated with increased osteoporosis risk compared with hysterectomy alone when the procedure was performed before age 50 (HR 1.46, 95% CI 1.28–1.67 at age 40; 1.24, 1.11–1.37 at age 45; and 1.10, 1.02–1.18 at age 50), with little difference thereafter.
HBO before age 45 was associated with increased fracture risk, though confidence intervals included the null (HR 1.15, 95% CI 0.97–1.37 at age 40; 1.12, 95% CI 0.98–1.29 at age 45). No clear difference in osteoporosis or fracture risk was observed between HUO and hysterectomy alone.
Conclusions:
Study findings suggest that conserving at least one ovary during premenopausal hysterectomy may be important for bone health.