For Most Women, Hysterectomy Does Not Affect Sexuality

Most women who have a hysterectomy see no dramatic changes in their sex lives, according to a recent commentary published by Israeli researchers in the Journal of Sexual Medicine.

In fact, some women may feel that their sex lives improve after the surgery if it relieves gynecological symptoms, such as pain, abnormal bleeding, incontinence, or bowel problems.

A hysterectomy is a surgical procedure that involves removing woman’s uterus. Depending on the reason for the hysterectomy, other organs, like the cervix, fallopian tubes, and ovaries are also removed. After the surgery, a woman will no longer menstruate, and she cannot have any children.

There are many reasons a woman might have a hysterectomy, including uterine fibroids, endometriosis, and cancer. Pelvic organ prolapse, in which the pelvic organs “fall” into the vagina, is another reason.

The authors of the commentary examined a number of studies on the sexual implications of hysterectomy for benign reasons, ones that improve quality of life (as opposed to malignant reasons, in which saving or prolonging life are the goals).

They also considered the type of hysterectomy performed. For example, in a subtotal hysterectomy, the upper part of the uterus is removed, but the cervix is not. With a total hysterectomy, both of these organs are removed completely.

In the past, experts believed that a subtotal hysterectomy was better for a woman’s post-surgical sexual function because nerve endings could be spared with this approach. However, more recent and “solid” research suggests there are no differences between these techniques in terms of sexual function.

Some women report feeling changes in genital sensation after hysterectomy, but these changes are “comparatively minor,” the authors noted.

There are emotional aspects to consider as well. The authors looked at studies comparing hysterectomy with uterus-sparing procedures. Over the course of several years, it appeared that women who undergo either procedure have similar rates of sexual satisfaction.

Still, some women feel less complete when their uterus is removed. This change in body image could affect them emotionally and sexually, the researchers explained.

Overall, symptom relief may still contribute much to sexual satisfaction, the authors noted.

“For pelvic pain and heavy bleeding, surgical options could be the long-awaited solution that ultimately improves sexual function and enhances quality of life,” they wrote.

They added that women should be “counseled on the medical and psychological benefits” before surgery.

Resources

The American Congress of Obstetricians and Gynecologists

“Hysterectomy”
(March 2015)
http://www.acog.org/Patients/FAQs/Hysterectomy


Cleveland Clinic

“What You Need to Know About Hysterectomy”
(Last review: May 15, 2012)
http://my.clevelandclinic.org/health/treatments_and_procedures/hic_What_You_Need_to_Know_About_Hysterectomy


The Journal of Sexual Medicine

Burke, Yechiel Z. MD and Lior Lowenstein, MD, MS, MHA
“Current Practice in Hysterectomy for Benign Reasons and Its Effect on Sexual Function”
(Full-text. First published online: July 18, 2016)
http://www.jsm.jsexmed.org/article/S1743-6095(16)30278-8/fulltext