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by qwen3.7-flash, 2026-08-25
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This secondary analysis of 1047 premenopausal women undergoing hysterectomy for benign conditions examined the impact of concurrent bilateral oophorectomy on depressive symptoms at twelve months post-surgery. The study found that while baseline depressive symptoms persisted regardless of ovarian removal, women without initial symptoms had a significantly reduced risk of developing depression if they underwent oophorectomy compared to those who retained their ovaries. These results held true after adjusting for demographic factors and surgical diagnoses, indicating that removing ovaries does not negatively affect mood in women who are already asymptomatic. Relevance to endometriosis: The paper cites surgical diagnosis of endometriosis as a covariate in its statistical model, noting that women having bilateral oophorectomy were likelier to have this condition, but it is centrally about the psychiatric outcomes of surgical menopause rather than the pathophysiology or treatment of endometriosis itself.
Abstract
Although depressive symptoms have been related to levels of reproductive hormones, especially in the perimeno-pausal period, the effects on such symptoms of surgical menopause, induced by bilateral oophorectomy, are uncertain. Many women having this procedure are concerned about postoperative mood disorders, particularly depression. This study is a secondary analysis of data from a cohort of 1047 premenopausal women aged 18 and older who underwent hysterectomy for benign conditions such as cervical dysplasia and endometrial hyperplasia, 433 of them with, and 614 without bilateral oophorectomy. Depressive symptoms were assessed using the Profile of Mood States Survey preoperatively and 12 months after surgery. Women having bilateral oophorectomy were older than the others and likelier to have endometriosis, but there were no group differences in race, income, mean body mass index, obesity, smoking status, or chronic pelvic pain. About one third of women in each group had depressive symptoms at the time of surgery. Depressive symptoms were present 12 months postoperatively in 26% of women with, and 7% of those without symptoms at baseline. Oophorectomy was associated with a reduced risk of depressive symptoms in women lacking such symptoms at baseline; the risk ratio (RR) was 0.36, with a 95% confidence interval (CI) of 0.17-0.78. The risk of depressive symptoms at follow-up did not change significantly in women having symptoms at baseline (RR, 1.21; 95% CI, 0.73-2.00). Bilateral oophorectomy remained associated with a decreased risk of depressive symptoms in women lacking symptoms at baseline after adjusting for age, race, parity, income, a surgical diagnosis of endometriosis, and current smoking status. These findings are not expected to alter decision-making with regard to performing bilateral oophorectomy at the time of hysterectomy. They may, however, help to reassure women that depressive symptoms are not likely to develop postoperatively if they are not present at the time of surgery.
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Bilateral Oophorectomy and Depressive Symptoms 12 Months After Hysterectomy
- Jacqueline Rohl
- Kristen Kjerulff
- Patricia Langenberg
- John Steege
Although depressive symptoms have been related to levels of reproductive hormones, especially in the perimenopausal period, the effects on such symptoms of surgical menopause, induced by bilateral oophorectomy, are uncertain. Many women having this procedure are concerned about postoperative mood disorders, particularly depression.
This study is a secondary analysis of data from a cohort of 1047 premenopausal women aged 18 and older who underwent hysterectomy for benign conditions such as cervical dysplasia and endometrial hyperplasia, 433 of them with, and 614 without bilateral oophorectomy. Depressive symptoms were assessed using the Profile of Mood States Survey preoperatively and 12 months after surgery. Women having bilateral oophorectomy were older than the others and likelier to have endometriosis, but there were no group differences in race, income, mean body mass index, obesity, smoking status, or chronic pelvic pain. About one third of women in each group had depressive symptoms at the time of surgery.
Depressive symptoms were present 12 months postoperatively in 26% of women with, and 7% of those without symptoms at baseline. Oophorectomy was associated with a reduced risk of depressive symptoms in women lacking such symptoms at baseline; the risk ratio (RR) was 0.36, with a 95% confidence interval (CI) of 0.17–0.78. The risk of depressive symptoms at follow-up did not change significantly in women having symptoms at baseline (RR, 1.21; 95% CI, 0.73–2.00). Bilateral oophorectomy remained associated with a decreased risk of depressive symptoms in women lacking symptoms at baseline after adjusting for age, race, parity, income, a surgical diagnosis of endometriosis, and current smoking status.
These findings are not expected to alter decision-making with regard to performing bilateral oophorectomy at the time of hysterectomy. They may, however, help to reassure women that depressive symptoms are not likely to develop postoperatively if they are not present at the time of surgery.
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