{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T14:13:50Z","timestamp":1788444830157,"version":"build-2803163510"},"reference-count":37,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"unspecified","delay-in-days":20,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,7,8]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The focus of the present study is to highlight and understand the effect of hysterectomy on physical, psychological, social and marital status among women aged under 40 years of age, in the cultural context of Pakistan<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>The study used a qualitative phenomenological approach to explore the lived experiences of the women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Settings<\/jats:title>\n                    <jats:p>The present study was conducted at Sheikh Zayed Hospital, a tertiary care public sector hospital located in Lahore, Pakistan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>The participants of the study were women under 40 years of age who have undergone hysterectomy in the last 2 years. The data of such women were recruited from the hospital and were selected using pre-defined inclusion and exclusion criteria through purposive sampling. In-depth interviews were conducted with seven women, and data were analysed thematically.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Four major themes and 12 sub-themes evolved during data analysis that included 1) physical and psychological effects (physical changes and recovery period, the tragedy of invisible loss of an organ and emotional distress and mood swings); 2) family and communal dynamics (reaction of in-laws, reaction of parents and siblings and reaction of friends and colleagues); 3) role fulfilment (wife and child bearer, sick role, professional role and domestic role) and 4) effects on marital life (relationship with husband and insecurity of the possibility of husband taking a second wife).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The present study found that women who have undergone hysterectomy before the age of 40 years have adverse physical, psychological, social and marital effects in their lives due to lack of societal support and acceptance related to the anatomical procedure. These findings highlight the profound influence of socio-cultural expectations and familial dynamics on women\u2019s post-hysterectomy experiences, underscoring the need for greater awareness and sensitivity toward their physical and psychosocial well-being.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-110262","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T13:40:51Z","timestamp":1784641251000},"page":"e110262","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Lived experiences of hysterectomy and its effects on the physical, psychological, social and marital life of women under 40 years of age: a qualitative phenomenological study conducted in Lahore, Pakistan"],"prefix":"10.1136","volume":"16","author":[{"given":"Muhammad Mohsin","family":"Aftab","sequence":"first","affiliation":[{"name":"Department of Public Health, Green International University, Lahore, Punjab, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6357-3947","authenticated-orcid":false,"given":"Ruhma Binte","family":"Shahzad","sequence":"additional","affiliation":[{"name":"Faculty of Behavioral and Social Sciences, University of the Punjab, Lahore, Punjab, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahnawar","family":"Ali","sequence":"additional","affiliation":[{"name":"Jinnah Hospital Lahore, Lahore, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naseem Noor","family":"Elahi","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Dera Ghazi Khan Medical College, Dera Ghazi Khan, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamda","family":"Shahzad","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Hameed Latif Hospital, Lahore, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohsin","family":"Arshad","sequence":"additional","affiliation":[{"name":"Department of Public Health, University of the Punjab, Lahore, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"key":"2026090306254004000_16.7.e110262.1","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1590\/1806-9282.20210093","article-title":"Epidemiological analysis of hysterectomies performed at the public health system in the largest Brazilian city","volume":"67","author":"Augusto","year":"2021","journal-title":"Revista Da Associa\u00e7\u00e3o M\u00e9dica Brasileira"},{"key":"2026090306254004000_16.7.e110262.2","doi-asserted-by":"crossref","DOI":"10.1186\/s12905-024-03338-y","article-title":"Prevalence of hysterectomy and its determinants in northern Iran: enrollment results of the Tabari cohort study","volume":"24","author":"Moosazadeh","year":"2024","journal-title":"BMC Womens Health"},{"key":"2026090306254004000_16.7.e110262.3","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.ejogrb.2013.12.017","article-title":"Psychological outcomes after hysterectomy for benign conditions: a systematic review and meta-analysis","volume":"174","author":"Darwish","year":"2014","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"2026090306254004000_16.7.e110262.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2005.05.009"},{"key":"2026090306254004000_16.7.e110262.5","doi-asserted-by":"crossref","first-page":"230","DOI":"10.4103\/ijnmr.IJNMR_146_20","article-title":"Iranian Women\u2019s Self-concept after Hysterectomy: A Qualitative Study","volume":"26","author":"Goudarzi","year":"2021","journal-title":"Iran J Nurs Midwifery Res"},{"key":"2026090306254004000_16.7.e110262.6","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1007\/s00737-024-01419-3","article-title":"Examining the changes in women\u2019s lives after the hysterectomy operation: Experiences of women from Turkey","volume":"27","author":"Turan","year":"2024","journal-title":"Arch Womens Ment Health"},{"key":"2026090306254004000_16.7.e110262.7","doi-asserted-by":"crossref","unstructured":"Sathar Z , Rashida G , Hussain S , et al . 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