The Link Between Hysterectomy and Depression

Abstract

This paper reviews the current literature on the possible link between hysterectomy and depression. Psychological hypotheses for such a link are discussed. The literature is divided fairly evenly into those papers which support a definite association between hysterectomy and post-operative depression and those which refute any such link. A summary of these papers is given with a critical discussion of the various methodologies and operational definitions used. No clear-cut association can be found on review of these studies, but in those papers which do suggest an association, the risk factors of a history of pre-operative depression, no organic uterine pathology and hysterectomy in young women of child bearing age are common to most. The point is made that depression occurring after hysterectomy is more likely to be associated with the social and psychological consequences of organ removal than with the operative procedure itself, and therefore, one may not expect the condition to become clinically obvious for anywhere from six months to two years post-operatively. The authors conclude that care should be taken in performing hysterectomy where the indications are equivocal, especially if the above alleged risk factors are present. A plea is made for more research in this area to determine whether hysterectomy is a factor in the etiology of depression in some women, and if so, which women are at risk.