Hysterectomy and sex?

Every year, many women all over the world will undergo a hysterectomy, the removal of their uterus. The majority of hysterectomies are performed to treat conditions such as fibroids, heavy bleeding, endometriosis/adenomyosis and prolapse. The development of several new treatments for these conditions may see a reduction in the number of hysterectomies currently performed. Deciding whether to have a hysterectomy can be a difficult and emotional process. By becoming informed about the procedure, women can confidently discuss available options, concerns and wishes with their doctor, and make a decision that is right for them. It is important that women understand the full implications of the removal of certain reproductive organs so that they can be properly prepared for any resultant side effects. The incidence of depression following hysterectomy is dependent on a number of factors, including: childbearing status (completed childbearing, hoping for a child or further children) psychological well-being and outlook before the operation; symptom relief; and post-surgery complications or side effects (such as those associated with an instant menopause). Women who are rushed into the procedure and have not had the time and opportunity to come to terms with the various changes a hysterectomy will bring, are more likely to develop depression[1]. Signs of depression may include severe and prolonged feelings of sadness and hopelessness; diminished interest in activities; significant weight loss or gain; insomnia; fatigue; and thoughts of death or suicide. Women suffering from post-hysterectomy depression should consult either their general practitioner or a counsellor, and may also find joining a support group helpful. Sexual intercourse is not recommended until the top of the vagina has safely healed, approximately 6–8 weeks after hysterectomy. During this time women may wish to focus on other activities besides intercourse such as hugs, kisses and massage. Studies have shown that women's participation in regular sexual activity may actually increase following a hysterectomy[2]. This is due to the fact that the common conditions for which women have a hysterectomy often make sex uncomfortable or even painful. Feeling unwell can also interfere with a woman's interest in sex. However, women who have their ovaries removed during a hysterectomy may experience vaginal dryness and thinness which can make sexual intercourse uncomfortable. These women may also find they have a loss of libido following a hysterectomy due to the drop in the hormone testosterone. Testosterone, sometimes referred to as the ‘libidinal hormone’, appears to be responsible for sex drive. When testosterone levels decline, women may report a decrease in sexual interest, sensation and/or frequency of orgasm. For some women, the loss of the uterus and cervix also appears to interfere with their sexual responsiveness. The uterus is a contractory organ, elevating during sexual excitement and contracting with orgasm. For women who were aware of these uterine sensations prior to having a hysterectomy, the operation may result in them feeling a change in sexual sensations. Similarly, some women gain sexual pleasure and orgasm from having the cervix repeatedly touched. This loss of the cervical stimulation may result in a woman experiencing difficulty in reaching orgasm or finding that her orgasms are less intense. It is important to note that a woman's partner is unlikely to notice any difference in sexual intercourse. Changes in the way a woman feels about herself can also have an impact on sexual desire and satisfaction. A common experience among women who have recently had a hysterectomy is that they feel less feminine or less womanly. For pre-menopausal women, their menstrual cycle may have played an important part in their sense of femaleness and/or youthfulness. Many women also fear that their partners will see them differently following a hysterectomy. Support and reassurance from a partner is, therefore, of great importance to women who are trying to come to terms with the emotional effects of a hysterectomy. Women experiencing negative feelings may find visiting a psychologist, counsellor or sex therapist helpful.


Read More: http://informahealthcare.com/doi/full/10.1080/13625180500430200