Anxiety, depression and stress among post-hysterectomy women / postmenopausal women: IJOGR
Menopause is a natural developmental stage in a woman's life that occurs with aging, characterized by hormonal and physical changes. These changes significantly impact women's socio-mental well-being, with a notable increase in depressive symptoms during this phase.
Studies indicate that 26% to 33% of women experience depressive symptoms for the first time during menopause, manifesting as chronic fatigue, restlessness, concentration difficulties, and sleep disorders. Similarly, anxiety disorders, characterized by excessive worry and irrational thoughts, affect 7.3% of menopausal women, with prevalence estimates ranging between 5.3% and 10.4%.
Stress levels are also markedly elevated in postmenopausal women, with as many as 88.8% reporting significant stress. Stress, defined as the body's response to internal and external challenges, can exacerbate menopausal symptoms. While limited studies suggest that perceived stress decreases with age, the relationship remains inadequately explored.
Hysterectomy, the surgical removal of the uterus and menopause, the cessation of ovarian function. It is one of the most commonly performed gynecological procedures worldwide, with most surgeries addressing benign conditions such as fibroids, abnormal uterine bleeding, and endometriosis. These are significant events in a woman's life, each associated with profound physical, emotional, and psychological changes. While hysterectomy offers significant physical relief such as eliminating pain, heavy bleeding, and fears of malignancy, it also has psychological implications. Many women report positive outcomes, including improved quality of life, relief from anxiety about pregnancy, and increased sexual satisfaction.
However, hysterectomy can also lead to negative psychological effects, including anxiety, depression, and stress, particularly for women who struggle with the loss of fertility or the perceived impact on femininity and body image. These emotional responses may be influenced by preoperative mood, family dynamics, and resilience, which can predict postoperative psychological outcomes. Similarly, postmenopausal women face the natural transition marked by hormonal decline, which may lead to mood disturbances, including anxiety, depression, and stress.
The hormonal shifts associated with both hysterectomy and menopause are key contributors to psychological challenges. Estrogen and progesterone are known to play a role in mood regulation, and their decline may exacerbate vulnerability to mental health conditions. This study aimed to assess the prevalence and severity of anxiety, depression, and stress among post-hysterectomy or postmenopausal women.
The mean age of participants was 53.51 years. Anxiety was most commonly moderate (55%), with 30% experiencing mild anxiety. Depression was predominantly mild (81%), and stress was moderate (76%). Younger age, shorter time since menopause or hysterectomy, and lower socioeconomic status were identified as significant predictors of higher anxiety, depression, and stress levels. Anxiety, depression, and stress were most pronounced in women less than one-year post-event.
This present study highlighted the psychological impact of menopause and hysterectomy on women aged 40–65 years, focusing on anxiety, depression, and stress.
This study highlighted the prevalence and determinants of psychological distress of anxiety, depression, and stress among postmenopausal and post-hysterectomy women, emphasizing the influence of demographic, socioeconomic, and temporal factors. Younger participants, those within the first year of menopause or hysterectomy, and women from lower socioeconomic backgrounds were identified as the most vulnerable, with significantly higher levels of psychological distress. This study concluded that the prevalence of moderate anxiety was reported by 55% of participants, while mild depression affected 81%, and moderate stress was experienced by 76%. Severe distress, although less common, was present in a small proportion of participants, with 12% reporting severe anxiety, 5% severe depression, and 4% severe stress. These findings suggest that mild to moderate psychological distress is widespread in this population, reflecting the emotional and physiological challenges associated with post-menopause or post hysterectomy. The results highlight the need for focused mental health interventions to alleviate distress and improve psychological well-being among these women. Special attention should be given to those at higher risk, including younger women, those in the early post-event phase, and those from lower socioeconomic backgrounds.
Source: Kalaiselvi P S et al. / Indian Journal of Obstetrics and Gynecology Research 2025;12(3):469–474
