When a woman has a hysterectomy, her uterus is surgically removed. If necessary, other reproductive organs, such as the cervix, fallopian tubes, or ovaries, may also be removed. Hysterectomies are performed for many reasons, including cancer, uterine fibroids, endometriosis, and pelvic organ prolapse.
Usually, a woman’s sexual function doesn’t change significantly after a hysterectomy, according to commentary by Israeli researchers published by the Journal of Sexual Medicine in 2016.
Some women find their sexual function improves because symptoms like pain, abnormal bleeding, incontinence, and bowel problems often get better. They may feel more confident, less depressed, and less anxious, all of which can improve sexuality.
However, there are times when women do have sexual issues after hysterectomy. For example, if a woman has her ovaries removed, her body will no longer produce as much estrogen and testosterone, two hormones that are important for sexual function.
Lower estrogen levels affect the vagina. Typically, estrogen keeps vaginal tissues elastic and moist. But with less estrogen, the vagina can become brittle and dry. Poorer vaginal lubrication can make intercourse uncomfortable and, sometimes, painful. Anticipation of discomfort can make it difficult for women to relax during sex, too.
Women who have trouble with vaginal lubrication should talk to their gynecologist. Sometimes a lubricant is all that’s needed. Or, the doctor might prescribe hormone therapy.
A woman might also struggle with body image after a hysterectomy. After surgery, she no longer menstruates and cannot become pregnant. Some women feel that this makes them less feminine or less “complete.” Such emotional issues can take their toll on sexuality, but a therapist or counselor can help.
Women should always feel free to discuss the sexual implications of hysterectomy with their doctor. Knowing what to expect can help women prepare themselves and their partners for any challenges. But they might also look forward to better sex in the months and years ahead.