Osteoporosis Risk May Increase After Hysterectomy

Women who have undergone hysterectomy may be at an increased risk for osteoporosis or bone fracture, according to results of a new study.

“Hysterectomy is thought to be related to multiple comorbidities because it might be related to earlier physiological menopause than in the general population, which results in earlier hormonal changes and may be related to osteoporosis and bone fractures,” the researchers wrote.

To assess this relationship, the researchers analyzed data on 9189 women aged 30 years or older from Taiwan who underwent hysterectomy between 2000 and 2012, as well as 33,942 age-matched women without a hysterectomy.

All of the women were followed for a median time of approximately 7 years. The researchers compared the incidence rate and hazard ratios of osteoporosis and bone fracture among women who had undergone hysterectomy vs women who had not. 

The adjusted hazard ratio of subsequent osteoporosis or bone fracture was higher among the women who underwent hysterectomy than among the comparison group. In fact, after a median follow-up time of 6.66 years, women with hysterectomy had an overall 2.26-fold higher risk of developing osteoporosis or fracture. These women also had a 4.92-fold higher risk of vertebral fracture compared with the group who had not had hysterectomy.

Compared with the non-hysterectomy group, the hysterectomy group’s risk of vertebral fracture was 4.33-fold higher in 5 years or less of follow-up time, 3.89-fold higher after 5 to 9 years of follow-up, and 5.42-fold higher after more than 9 years of follow-up 

The subgroup analysis showed that both groups experienced an increased risk of osteoporosis or fracture due to oophorectomy or estrogen therapy.

“Hysterectomy might be associated with the slightly increased risk of osteoporosis and vertebral fracture in middle-aged women,” the researchers concluded. “Based on the study results, women who undergo hysterectomy should be screened more readily or counseled regarding this risk of osteoporosis or fracture.”

—Colleen Murphy

Reference:

Yeh YT, Li PC, Wu KC, et al. Hysterectomies are associated with an increased risk of osteoporosis and bone fracture: a population-based cohort study. PLoS One. 2020;15(12):e0243037. doi:10.1371/journal.pone.0243037