Monday, May 6, 2019

Hysterectomy Associated With Increased Risk of Bipolar Disorder, Study Suggests

Women who receive a hysterectomy are more than twice as likely to develop bipolar disorder as women who do not undergo this procedure, according to a study published in Depression and Anxiety. This risk of bipolar following hysterectomy is even greater for women who had endometriosis or were taking Premarin (a form of estrogen therapy) at the time of surgery.

“To our knowledge, this is the first study to longitudinally evaluate [the incidence of] bipolar disorder in a national sample of women who have undergone a hysterectomy,” wrote Yu‐Chih Shen, M.D., Ph.D., of Taiwan’s Tzu Chi University and colleagues. “The knowledge of how surgical or natural hormonal withdrawal influences mood is fundamental and emphasizes the importance of coordinated psychiatric and gynecological care.”

Shen and colleagues analyzed health record data from 4,337 women aged 30 to 50 in Taiwan who underwent a hysterectomy between 2000 and 2013 along with 17,348 age-matched women who did not have this procedure. During a roughly eight year follow-up period, 20 women who underwent a hysterectomy and 28 who did not developed bipolar disorder. Nineteen of the 20 bipolar diagnoses in the hysterectomy group occurred more than one year after the surgery.

The researchers found that women who underwent a hysterectomy were more than twice as likely to subsequently develop bipolar disorder. This risk was raised to more than three times as likely among women who had endometriosis at the time of their surgery (the presence of endometriosis also resulted in a slightly elevated risk of bipolar disorder among women who did not have a hysterectomy). Women who were taking Premarin at the time of hysterectomy also had more than three times the risk of developing bipolar disorder. There was no elevated risk among women taking estradiol, another type of estrogen therapy, at the time of their hysterectomy, nor was there any elevated risk of bipolar disorder among women taking Premarin who did not have a hysterectomy.

For related information, see the Psychiatric News article “Early Surgical Menopause Found to Have MH Effects.”

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