The risk of developing bipolar disorder was more than double in women who received a hysterectomy, compared with those who did not undergo the procedure, in a study published online in Depression and Anxiety.
“Knowledge about how surgical or natural hormonal withdrawal influences mood is fundamental and emphasizes the importance of coordinated psychiatric and gynecological care,” researchers wrote.
The study compared 4337 women in Taiwan between 30 and 50 years old who received a hysterectomy with 17,348 women matched for age who did not undergo a hysterectomy.
Over nearly 8 years of follow-up, 20 women who had a hysterectomy and 28 women who did not receive developed bipolar disorder. Nineteen of the 20 women who developed bipolar disorder after hysterectomy were diagnosed more than 1 year after the procedure, according to Psychiatric News coverage.
Women who underwent a hysterectomy were more than twice as likely to develop bipolar disorder, the study found. Endometriosis and Premarin (conjugated estrogen tablets) use at the time of the hysterectomy tripled the incidence of bipolar disorder.
Women taking estradiol at the time of their hysterectomy and women taking Premarin who did not undergo a hysterectomy did not have an increased risk of bipolar disorder, Psychiatric News reported. Meanwhile, women with endometriosis and no hysterectomy had a slightly elevated risk of bipolar disorder.
“This study concluded that women with hysterectomy have an increased risk of bipolar disorder,” researchers wrote. “Endometriosis and hormone therapy may add to the risk of bipolar disorder after hysterectomy.”
Shen YC, Chen W, Tsai IJ, Wang JH, Lin SZ, Ding DC. Association of hysterectomy with bipolar disorder risk: a population-based cohort study. Depression and Anxiety. 2019 April 26;[Epub ahead of print].