Objective : To analyse determinants of hysterectomy for benign uterine cond
itions with or without oophorectomy in Italy, a country with among the lowe
st rates of hysterectomy worldwide. Methods: Between 1997 and 1999, a large
cross sectional study was conducted on the characteristics of women around
menopause attending a network of first level outpatients menopause clinics
in Italy for general counselling about menopause or treatment of menopausa
l symptoms. A total of 25 644 women entered the study. Characteristics of w
omen who underwent and women who did not undergo hysterectomy and oophorect
omy were compared. Results: Out of the 25 644 women considered, 4727 were h
ysterectomized (18.4%). Mean age at surgery was 46.8 years. The OR of hyste
rectomy decreased with increasing educational level: in comparison with wom
en with primary and none education, the OR of hysterectomy was 0.8 (95% CI
0.7- 0.9) and 0.6 (95% CI 0.5-0.7) respectively for women with intermediate
or high/university degree. Body mass index (BMI, kg m(-2)) was related to
the frequency of hysterectomy; in comparison with women with BMI less than
or equal to 23.8, the OR of hysterectomy was 1.2 (95% CI 1.1-1.3) and 1.4 (
95% CI 1.2-1.5) respectively for women with a BMI 23.8-27.2 and > 27.2. The
frequency, of bilateral oophorectomy increased with age at hysterectomy: i
n comparison with women who have had hysterectomy when aged less than or eq
ual to 43 years, the OR of bilateral oophorectomy during hysterectomy was r
espectively 1.9, 3.4 and 4.3 in women who had hysterectomy at age 44-47, 48
-51 and greater than or equal to 52 years. The Frequency of bilateral oopho
rectomy was lower in more educated women: in comparison with women reportin
g none or primary degree, the OR was 1.0 and 0.8 respectively for women wit
h intermediate and high/university degree. Conclusions: The results of this
analysis indicate that hysterectomy for benign conditions is more frequent
ly performed in less educated women, in nulliparae and in women with higher
BMI. During hysterectomy for benign conditions, bilateral oophorectomy is
more frequent in less educated women and its frequency increases with women
's age. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.