Life expectancy in India has risen substantially, particularly among women, resulting in a large proportion of female population transitioning through reproductive and post-reproductive stages. An increase in hysterectomy, often leading to surgical menopause, has emerged as a significant health concern, yet it is insufficiently studied. Since limited evidence exists on hysterectomy across various age groups and other demographic profiles, the present study examines the prevalence of hysterectomy among women aged 30–39 years and 40–49 years and their geographic, socioeconomic, and health-related associates. Additionally, we estimated the proportion of ‘young-age hysterectomy’ in India, i.e. the proportion of women who underwent hysterectomy during adolescence (15–19 years), or young adulthood (20–29 years). Data from the last two rounds of the National Family Health Survey (NFHS 2015–16 and 2019–21) were analysed. Spatial variation in hysterectomy prevalence was assessed using choropleth mapping. Descriptive analysis and binary logistic regression analysis were applied to identify socio-economic and health-related determinants. Results from the recent NFHS data found that hysterectomy prevalence among women aged 30–49 years was highest in Bihar, followed by Telangana, Andhra Pradesh, and Karnataka. The proportion of hysterectomies during adolescence (15–19 years) was high in Assam and West Bengal, and during young adulthood (20–29 years) in Telangana and Andhra Pradesh. Excessive menstrual bleeding or pain was reported as the leading cause of hysterectomy. Logistic regression analysis found that rural residence, lack of education, and wealth index were significant socio-economic determinants of undergoing hysterectomy. Other correlates included obesity, high parity (≥ 4 children), anaemia, and contraceptive use, especially female sterilisation. The findings emphasise the need to improve women’s educational and nutritional status and to enhance awareness of gynaecological health. Targeted interventions in high-prevalence states, informed consent, and alternative treatment approaches to women’s health are important to reducing unnecessary hysterectomies and improving overall reproductive health outcomes.
Ghosh et al. (Sun,) studied this question.