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Studies compare hysterectomy vs. other medical treatments for abnormal uterine bleeding

Two studies published in the March 24/31 issue of The Journal of the American Medical Association (JAMA) look at the effect of medical treatment compared with hysterectomy on health-related quality of life for women with abnormal uterine bleeding.

According to background information in one of the articles, the Medicine or Surgery (Ms) randomized trial: "Hysterectomy [removal of the uterus] is the most common major surgical procedure performed in the United States for nonobstetric reasons. In 2000, approximately 633,000 hysterectomies were performed, and U.S. women have an estimated 25 percent risk of having their uterus removed." The authors note that most hysterectomies are elective and performed before menopause for abnormal uterine bleeding and other non-life-threatening reasons.

Miriam Kuppermann, Ph.D., M.P.H., from the University of California, San Francisco and colleagues from the Ms Research Group, studied 63 premenopausal women, aged 30 to 50 years, who had abnormal uterine bleeding for a median (mid-point) of four years despite a variety of medical treatments, including hormone therapy (such as medroxyprogesterone acetate). The women were randomly assigned to undergo hysterectomy (n=31) or expanded medical treatment (n=32). The authors assessed overall mental health as the primary outcome, using the Mental Component Summary (MCS) of the 36-Item Short-Form Health Survey (SF-36). Secondary outcomes included physical health, symptom resolution and satisfaction, body image and sexual functioning. The participants were followed-up for two years.

"At 6 months, women in the hysterectomy group had greater improvement in MCS scores than women in the medicine group (8 vs. 2)," the authors report. "They also had greater improvement in symptom resolution (72 vs. 29), symptom satisfaction (44 vs. 7), interference with sex (41 vs. 22), sexual desire (21 vs. 3), health distress (33 vs. 13), sleep problems (13. vs. 1), overall health (12 v
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Contact: Eve Harris
415-885-7277
JAMA and Archives Journals
23-Mar-2004


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