• Sex After a Hysterectomy: Never Better

    IMAGE Despite the fact that many American women have their uteri surgically removed each year, most women do not sign up for the procedure unless there is a good reason. In addition to the usual worries about major abdominal surgery, they are concerned about how a hysterectomy will affect their health and lives, especially their sex lives. Sexual functioning actually may be foremost in women's minds before surgery.
    However, there is good news about sex after hysterectomy. A study revealed that hysterectomy can have very positive effects on a woman's sex life, especially if she was experiencing significant medically related sexual problems before surgery.

    The Good News

    Published in the Journal of the American Medical Association , the Maryland Women's Health Study followed the experiences of 1,101 women during the first two years after a hysterectomy. The results were surprisingly positive. Overall, the study group's frequency of sexual relations increased after surgery, and the number of women experiencing pain during sex dropped from 41% to 15%. Although improvements in vaginal dryness were not as marked, women in the study group did report strong orgasms almost 15% more frequently one year after surgery. Even more impressively, almost three-quarters of the women initially experiencing low libido reported an improvement after surgery, and two-thirds of the women who reported not having orgasms before hysterectomy were having them a year later.

    A Change in Thinking?

    Although hysterectomies are very common among major surgeries performed in the United States, the procedure has not had the best reputation among the general public. Common knowledge held that removal of the uterus was the cause of many problems, including increased vaginal dryness, painful intercourse, lack of interest in sex, and lower number and quality of orgasms.
    However, the study results did not come as a surprise to some experts. Women usually have the procedure because they are experiencing medical problems; therefore, it is logical that their quality of life would improve after surgery.

    All Hysterectomies Are Not the Same

    One cause of the confusion about hysterectomy's affect upon sexual functioning may have been the public's assumption that all hysterectomies are the same. They are not. Sometimes the ovaries are removed along with the uterus, and in other cases they are left intact. Although the uterus is thought to play a role in women's hormonal functioning, the ovaries are the master producers of estrogen and the regulators of the menstrual cycle. When the ovaries are removed, women may experience the sexual problems that are commonly associated with hysterectomy, such as painful intercourse and vaginal dryness.

    Preparation: Key to a Positive Outcome

    Along with the practical and emotional preparation, it is important for women and their partners to have realistic expectations about recovery.
    Knowing what to expect, makes changes easier to accept in a positive light. Because hysterectomy also releases many women from previous medical problems and fear of pregnancy, the odds seem to be stacking up in favor of great sex after hysterectomy.

    RESOURCES

    American Congress of Obstetricians and Gynecologists http://www.acog.org/

    National Women's Health Information Network http://www.womenshealth.gov/

    CANADIAN RESOURCES

    The Society of Obstetricians and Gynaecologists of Canada http://www.sogc.org

    Women's Health Matters http://www.womenshealthmatters.ca/

    References

    Hysterectomy. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 18, 2012. Accessed July 26, 2012.

    Hysterectomy fact sheet. WomensHealth.gov website. Available at: http://womenshealth.gov/publications/our-publications/fact-sheet/hysterectomy.cfm#g. Updated December 15, 2009. Accessed July 26, 2012.

    Rhodes J, Kjerulff K, Langenberg P, et al. Hysterectomy and sexual functioning. JAMA 1999 Nov 24;282(20):1934

    Komisaruk BR, Frangos E, Whipple B. Hysterectomy improves sexual response? Addressing a crucial omission in the literature. J Minim Invasive Gynecol. 2011 May-Jun;18(3):288-95.

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