• BMC women's health · Jan 2014

    Educational level, prevalence of hysterectomy, and age at amenorrhoea: a cross-sectional analysis of 9536 women from six population-based cohort studies in Germany.

    • Andreas Stang, Alexander Kluttig, Susanne Moebus, Henry Völzke, Klaus Berger, Karin Halina Greiser, Doris Stöckl, Karl-Heinz Jöckel, and Christa Meisinger.
    • Institut für Klinische Epidemiologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Str, 8, 06112 Halle (Saale) Halle, Germany. andreas.stang@uk-halle.de.
    • BMC Womens Health. 2014 Jan 1;14:10.

    BackgroundHysterectomy prevalence has been shown to vary by education level. Hysterectomy influences age at amenorrhoea. The aim of this study was to examine these associations in Germany within population-based data sets.MethodsBaseline assessments in six population-based cohorts took place from 1997 through 2006 and included 9,548 women aged 20-84 years. All studies assessed hysterectomy history, school and professional degrees. Degrees were categorized into three levels each. Adjusted prevalence ratios and 95% confidence intervals (95% CI) were estimated.ResultsPrevalences were higher in West Germany than East Germany, increased by age, and leveled off starting at 55-64 years. The age- and study-adjusted prevalence ratio (lowest versus highest school level) was 2.61 (95% CI: 1.28-5.30), 1.48 (95% CI: 1.21-1.81), and 1.01 (95% CI: 0.80-1.28) for women aged 20-45, 45-64, and 65 and more years respectively. The estimated adjusted prevalence ratios per one unit decrement of the educational qualification score (range 1 = lowest, 8 = highest) were 1.29 (95% CI: 1.02-1.64), 1.08 (95% CI: 1.04-1.12), and 0.98 (95% CI: 0.93-1.03) for women aged 20-44, 45-64, and 65-84 years respectively. Age at amenorrhoea was on average 6.2 years lower (43.5 years versus 49.7 years) among women with a history of hysterectomy than those without.ConclusionsLower educational level was associated with a higher hysterectomy prevalence among women aged 20-64 years. Several mediators associated with educational level and hysterectomy including women's disease risk, women's treatment preference, and women's access to uterus-preserving treatment may explain this association. At population level, hysterectomy decreases the age of amenorrhoea on average by 6.2 years.

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