• M Brunes, D Altman, M Pålsson, M W Söderberg, and M Ek.
• Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden.
• BJOG. 2021 Apr 1; 128 (5): 846-855.

ObjectiveTo evaluate how hysterectomy affects the prescription of analgesic, psychotropic and neuroactive drugs in women with endometriosis using population-based nationwide registers.DesignNationwide cohort study.SettingSwedish national registers, from 1 January 2009 to 31 December 2018.PopulationWomen with benign disease undergoing a total hysterectomy during the 4-year period of 2012-2015. Women with endometriosis (n = 1074) were identified and compared with women who did not have endometriosis (n = 10 890).MethodsProspectively collected data from two population-based registers were linked: the Swedish National Quality Register of Gynaecological Surgery and the Swedish National Drug Register. Multivariate logistic regression was used as the main statistical method.Main Outcome MeasuresChanges in drug prescription over time for 3 years prior to and 3 years after hysterectomy.ResultsThe frequency of prescription of analgesics was higher in women with endometriosis compared with women without endometriosis (OR 2.2, 95% CI 1.7-2.9). Among women with endometriosis, the prescription of analgesics (OR 1.0, 95% CI 0.8-1.2) did not decrease 3 years after hysterectomy compared with the 3 years prior to surgery. There was also a significantly higher rate of prescription of psychoactive (OR 1.6, 95% CI 1.4-2.0) and neuroactive drugs (OR 1.9, 95% CI 1.3-2.7) in the long term postoperatively.ConclusionsIn women undergoing hysterectomy, endometriosis was associated with a higher prescription rate of analgesics. In the endometriosis group the prescription of analgesic, psychoactive and neuroactive drugs did not decrease when comparing prescription rates for the 3 years prior to and the 3 years after surgery.Tweetable AbstractIn women with endometriosis, the long-term prescription of analgesics did not decrease after hysterectomy.© 2020 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.

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