Hysterectomy is a common gynaecological procedure - approximately 28,000 Australian women had this surgery in 2022. Hormonal changes precipitated by hysterectomy may result in loss of  muscle mass and strength leading to greater difficulty doing daily physical activities such as climbing stairs, carrying groceries or gardening.

Maintaining physical function is an important marker of healthy ageing. While being active, maintaining a healthy weight and not smoking are each separately associated physical capability, evidence suggests that the co-occurrence of these characteristics may give greater protection against physical decline. We investigated whether there was a cumulative protective effect of these characteristics on physical function limitations among women with a hysterectomy.

Our study included 2,509 women born in 1946-51 who participated in the Australian Longitudinal Study on Women’s Health. We used log-multinomial regression to assess the associations between combinations of protective characteristics and substantial limitations in physical function versus minimal limitations (measured by the Physical Functioning subscale of the Medical Outcomes Study Short Form Health Survey, SF-36)

Over 18 years of follow-up (2000-2018) we found that each of the protective characteristics reduced the likelihood of substantial limitations in physical function among women with a hysterectomy. There was a strong dose-response effect, whereby women with any one of these characteristics were 38% less likely to experience substantial limitations in physical function, women with any two of these characteristics were 61% less likely, and women with all three characteristics were 81% less likely to experience substantial limitations in physical function than women who smoked, were not active and not a healthy weight. Given the modifiable nature of smoking, physical activity and diet, this research potentially suggests that real benefits could come from proactive support and intervention strategies for women who have had a hysterectomy to assist in preventing declines in physical function as they age.