HORMONE REPLACEMENT AND MENOPAUSAL SYMPTOMS FOLLOWING HYSTERECTOMY

Hormone replacement therapy (HRT) is recommended for most women who ex perience surgical menopause following hysterectomy/oophorectomy for no ncancerous conditions; it is also commonly prescribed for postmenopaus al women. Beginning in 1992, 1,299 women undergoing hysterectomy in 28 hospitals throughout Maryland were interviewed prior to hysterectomy and were subsequently followed over a 2-year period. Interviews includ ed questions about HRT use and symptoms associated with menopause. The majority of the women (66 percent) were white, 55 percent had a high school education or better, 49 percent were obese (body mass index gre ater than or equal to 27.3), and 11 percent were postmenopausal. Over 40 percent of premenopausal women underwent bilateral oophorectomy. At 3 months posthysterectomy, 89 percent of these women were on HRT; thi s figure dropped to 85 percent at 24 months. Among postmenopausal wome n, 50 percent were on HRT both at 3 months and at 24 months posthyster ectomy. Among premenopausal women who had unilateral oophorectomy, 21 percent were on HRT at 3 months, increasing to 35 percent at 24 months . Among premenopausal women who had no ovaries removed, 5 percent were on HRT at 3 months, increasing to 13 percent at 24 months. There were few within-group differences between HRT users and nonusers, except t hat among postmenopausal women, HRT users were younger and more likely to be white and had higher income and educational levels. Women who w ere postmenopausal or who underwent bilateral oophorectomy were less l ikely to have hot flashes if they were on HRT, but women with 0-1 ovar y removed who were on HRT were more likely to have hot flashes than th ose not on HRT. Black women were significantly more likely to experien ce hot flashes than were white women, independent of HRT status and we ight. Obese women were on HRT at approximately the same rates as nonob ese women but were significantly more likely to have hot flashes, even when analyses controlled for HRT and race.