Hysterectomy, oophorectomy, and bone health: a systematic review and meta-analysis
Pooled result · FractureResult — go to the resultPooled relative risk 1.17 95% CI 1.03–1.33Authors' conclusion
Our review supports evidence showing that bilateral oophorectomy is negatively associated with bone health and suggests that hysterectomy alone may also increase osteoporosis risk, although more data are required. To support personalised clinical decision-making, further large-scale longitudinal studies with longer follow-up and detailed assessment of surgery extent, timing, and medication use are essential.
Study context
- Population
- Women aged ≥18 years; studies of hysterectomy and/or oophorectomy and fracture, osteoporosis or bone mineral density (BMD); PubMed, Embase, Cochrane Central, CINAHL to November 202429 studies
- Comparison
- Hysterectomy and/or oophorectomy vs no surgery or less extensive surgery
- Outcome
- Fracture
Methodological detailsModerate to high heterogeneity; most studies did not account for age at surgery, MHT use or surgical indications
- Moderate to high heterogeneity; most studies did not account for age at surgery, MHT use or surgical indications
Pooled result
As reported in the abstract
Pooled relative risk
1.17
95% CI 1.03–1.33
Bilateral oophorectomyvs No oophorectomy
pooled RR 1.17 (95% CI 1.03–1.33)
Further pooled results
| Outcome | RR (95% CI) | |
|---|---|---|
| OsteoporosisBilateral oophorectomyvs No oophorectomy4 studies; not statistically significant | 1.46 (0.94–2.27) | |
| FractureHysterectomy with bilateral oophorectomyvs Hysterectomy without oophorectomy4 studies | 0.99 (0.83–1.18) | |
| OsteoporosisHysterectomy without oophorectomyvs No surgery2 studies | 1.45 (1.37–1.53) | |
| 0.512Relative risk (log scale) |
Original publication
Hysterectomy, oophorectomy, and bone health: a systematic review and meta-analysis. Eur J Endocrinol. Published 22 August 2025. doi:10.
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