A hysterectomy is a very common medical procedure where the uterus
(womb), and sometimes the ovaries, Fallopian tubes or cervix, are removed.
Common reasons for
hysterectomies among include fibroids, heavy, irregular or
painful periods, prolapse, endometriosis, cancer and pelvic inflammatory
disease (PID), according to NSW obstetrician and
gynaecologist Dr Harvey Ward in an online article on Reproductivecare.com.au.
common question women ask about the effects of the procedure is how it will
affect their sex life. This isn’t really surprising since many women fear the procedure
will somehow reduce their femininity, make them sexually less attractive, or
diminish their status as a “complete” woman. Others fear that it may have a
physical impact, such vaginal dryness and resultant pain.
With some women finding it difficult to come
to terms with the emotional effects of a hysterectomy, Dr
Ward stresses the
importance of knowledge, support and reassurance from a partner.
Types of hysterectomies
First and foremost, it’s important to know and understand what your procedure
involves, and to discuss all matters relating to it with your gynaecologist, advises
the Royal Australian and New Zealand College of Obstetricians and
Gynaecologists (RANZCOG) on its website, Ranzcog.edu.au.
particular circumstances for having this procedure will determine the type of
hysterectomy you’ll undergo, why it must be done, which organs will be removed,
and the possible impact on your sex life.
The different kinds
of procedures include:
1. Hysterectomy: the surgical
removal of the uterus.
2. Total hysterectomy: removing the whole of the uterus and
3. Sub-total hysterectomy: removing the
uterus or womb but leaving the cervix intact. In addition to the hysterectomy,
the ovaries and the Fallopian tubes may also be removed.
4. Radical hysterectomy: this is performed when there is cancer in the
cervix or uterus. The whole uterus, tissue on the sides
of the uterus, the cervix, and the top part of the vagina is removed. The
procedure also involves taking additional tissue from the supports and tissues around
Will the hysterectomy change your sex life?
The impact of a
hysterectomy on a woman’s sex life depends on the type of procedure she has had,
comments obstetrician and gynaecologist Dr Dana B. Jacoby on Healthywomen.org.
“If your ovaries and
uterus are both removed, it may change your sexual desire. That’s because the
ovaries produce both testosterone and oestrogen hormones that are important in
intercourse and sexual desire,” he explains. Testosterone is believed to mostly
contribute to sexual desire, Dr Jacoby adds, while oestrogen loss may cause
vaginal dryness and thinning of vaginal tissue, which could make sex
Dr Sarah Choi, gynaecologist and advanced laparoscopic surgeon at Sydney
Women’s Endosurgery Centre (SWEC) notes
on her website Drsarahchoi.com.au that a woman who only has her uterus removed
can maintain her usual sexual activities after hysterectomy. Since the vagina
is preserved, sex may even improve, because the inconvenience and concern about
menstrual bleeding, troublesome symptoms as well as unplanned pregnancies and
birth control all disappear.
Most gynaecologists, including organisations such as RANZCOG, recommend only
having penetrative vaginal sex after six to eight weeks after surgery, when the
top of the vagina has healed properly and until you’ve gone for your post-operative
check-up. In the meantime, there are other ways to express your sexuality,
including hand stimulation, hugs, kisses and massage. This is the time to be
adventurous and try out new and exciting alternatives to penetrative vaginal
sex with your partner.
don’t feel ready to have sex after six weeks, don’t let it concern you. Healing
times differ for every woman. Remember to do the pelvic-floor
exercises that will be recommended by your surgeon. These exercises aid
recovery, tone the vaginal muscles and help improve sexual sensation.
After a hysterectomy, some women
may have less interest in sex or experience reduced sexual sensation, such as
less intense orgasms. But having a hysterectomy will
not prevent you from having an orgasm. You still have your clitoris and labia,
which are highly sensitive.
As your recovery progresses, your sexual desire may return, but if it
doesn’t and you’re concerned, try to discuss it with your partner so both of
you can have a good understanding of the challenges and work on them together.
If your hysterectomy entails having a vaginal
repair (to repair a prolapsed uterus affecting the front or back of the
vagina), the narrowing of the vagina may make sex uncomfortable or even
painful. The good news is that you can usually alleviate this by using a
water-based lubricant such as K-Y jelly, a vaginal cream or a soluble pessary (a
small soluble block that’s inserted into the vagina). Also try to increase your
body’s natural lubrication with appropriate foreplay.
Lastly, remember you don’t need to suffer in silence if you experience
sexual problems after having a hysterectomy. Discuss any concerns with your partner
and, of course, with your gynaecologist, GP or ask to be referred to a
counsellor who specialises in sexual health or ask our sexologist.
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Healthywomen; Thewomens ;Reproductivecare; NHS; Dr Sarah Choi; The hysterectomy association; Ranzcog ; Women's Health
Queensland Wide ; NHS Information for patients ; 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. ; Royal Women’s hospital Victoria (Australia) and UK National Health Service.