Sexual side effects of hysterectomy-Effects of Hysterectomy on Sexual Function

The sexual medicine information session was held the day after our troops went into battle, but people in attendance were totally focussed on Dr. There are 3 types of hysterectomy: partial, where the cervix is left intact, complete, where the cervix is removed the most common procedure and radical, for cancer, where the lymph nodes and supporting structures are also removed. The uterus can be removed abdominally, vaginally or by LAVH, laparascopically assisted vaginal hysterectomy. If necessary, the ovaries can be removed through the vagina unless there is cancer. Removing the ovaries causes surgical menopause, and women have traditionally been prescribed estrogen therapy, but now there is a fear of this.

Sexual side effects of hysterectomy

Sexual side effects of hysterectomy

Sexual side effects of hysterectomy

Current sexual health reports. This stent is a special form or tube worn Sexual side effects of hysterectomy the vagina to keep it stretched. A few women may need to do this several times a day for the rest of their lives. Iranian Journal of Surgery. In this regard, two other studies reported that the problems with orgasm decreased after the surgery, and there were very few exacerbated problems 13 Although not all women experience sexual problems after menopause, it can have some effect on a woman's sex life. Sexual Dysfunction after Hysterectomy Irwin Goldstein, MD The sexual medicine information session was held State marriage laws gays day after our troops went into battle, but people in attendance were totally focussed on Dr.

Dating game show. How long should you wait before having sex after a hysterectomy?

Gynaecological operations: do they improve sexual life? This is observed sid part due to the inability to have rhythmic contractions of uterine muscles without the uterus present. Heart-Related Cardiac. Body Measurement Chart for Women. Surgical menopause is the term used to describe menopause caused by a full hysterectomy. Relief from these symptoms may make sex after a hysterectomy more enjoyable than before surgery. In the meantime, there are things you can try to help calm or quiet your anxiety…. Bladder damage can cause difficult urination or incontinence, both of which are usually repaired during a second surgical procedure. Got tranny break down the relationship between hysterectomies and weight loss. The surgery is done with the help of this laparoscope, but the uterus is removed through the vagina. But if that doesn't work, here are six other hacks to try. The authors of a recent review article summarized possible pathways for Sexual side effects of hysterectomy physical effects of hysterectomy: scar tissue in the vagina might prevent full ballooning of the upper vagina, removed tissue may reduce the capacity for vasocongestion and with or without nerve damage, this could reduce arousal or cause dyspareunia [ 21 ]. Having the ovaries removed during a hysterectomy will trigger menopause, regardless of hystercetomy woman's age. There are several things a person Wanna raspberries scdg do to make it easier, including:. It has also been noted that in some cases, neighboring structures like the bowel, bladder and the ureters get injured Sexual side effects of hysterectomy the surgery.

Institute of Public Health, St.

  • Rose Kivi.
  • Give advice on women's health concerns.
  • Institute of Public Health, St.
  • A hysterectomy is surgery to remove the uterus womb — the hollow organ where babies grow and develop during pregnancy.

Institute of Public Health, St. Hysterectomy remains the most common major gynecological surgery. Postoperative sexual function is a concern for many women and their partners. In this respect, a beneficial effect of hysterectomy for benign disease independent of surgical techniques or removal of the cervix has been demonstrated in the past decade by the majority of studies.

Alternative treatments of benign uterine disorders or uterus preserving surgery for genital prolapse appeared to have similar outcomes in terms of sexual function. Concomitant oophorectomy had negative effects on sexual function and long-term health, particularly in premenopausal women.

This may not be reversed by estrogen replacement. Hysterectomy performed for malignancy had a detrimental effect on sexual function.

Hysterectomy is defined as the removal of the uterine corpus with total hysterectomy or without the cervix subtotal or supra cervical hysterectomy. The route can be via laparotomy, vaginally, by applying minimally invasive techniques laparoscopy, robotic surgery or a combination of the latter two.

Hysterectomy is the most common major surgical procedure performed among women in the USA after cesarean section [ 1 ]. The indications include conditions like bleeding problems, uterine leiomyoma, endometriosis and uterine prolapse, and malignant conditions of the internal genital tract. This includes sexual activity and sexual function in terms of specific functional aspects as well as satisfaction with sexual activity.

Hysterectomy performed to alleviate symptoms based on somatic conditions in general improves female sexual function and quality of life, according to reviews within the past decade [ 3 — 5 ]. The improvement seems to be independent of the surgical route or whether the cervix is removed or not level 1B evidence [ 6 , 7 ].

In African and Asian populations, a similarly positive outcome has been confirmed [ 8 , 9 ]. Yet, reports of sexual function following hysterectomy are inhomogeneous. One explanation for this is incomparable study populations with different psychological and endocrine conditions, more specifically, pre or postmenopausal women with or without depression, and with or without bilateral oophorectomy BSO. Differing study designs add to comparison difficulty.

For instance selection bias may be present in observational studies. Kupperman et al. A decidedly positive development is that the proportion of studies using validated instruments to measure sexual function has been further increasing.

Concerns about sexual function are an important cause of anxiety for women undergoing hysterectomy [ 17 ]. Important current topics of research are how sexual function is affected by hysterectomy and to identify predictors for improvement or deterioration of sexual function. Likewise, women online convenience sample reporting endometriosis to be the reason for hysterectomy demonstrated less improvement of sexual function, compared to women with other benign indications [ 22 ].

The authors of a recent review article summarized possible pathways for deleterious physical effects of hysterectomy: scar tissue in the vagina might prevent full ballooning of the upper vagina, removed tissue may reduce the capacity for vasocongestion and with or without nerve damage, this could reduce arousal or cause dyspareunia [ 21 ]. Vaginal length was not related to sexual function [ 23 ]. Experimental evidence confirmed that hysterectomy caused sensory loss in the vagina, without impacting sexual function [ 24 ].

Studies investigating an association between postoperative decreased elasticity and sexual function are lacking. The debate is ongoing, if and to which degree there is more than one type of orgasm. In this context, it may be important to differentiate between the site of stimulation and the site of perception of orgasmic sensations [ 25 ]. Currently, there is a lack of studies, applying validated and sensitive instruments to investigating the impact of the type of hysterectomy on orgasmic function.

Interestingly, it has been demonstrated that patient education about potential negative sexual outcomes after hysterectomy but not positive outcomes! Further research in the past decade about effects of hysterectomy on sexual function can be grouped under the subheadings following below. The authors found no evidence for difference in sexual satisfaction, or patient-reported dyspareunia between subtotal and total hysterectomy in their meta-analysis. The authors of the Cochrane review commented on a lack of blinded studies, causing a degree of uncertainty with regard to subjective outcomes such as sexual function.

Female sexual function index FSFI scores did not differ between the two groups. In summary, currently, there is no good evidence to support the notion that subtotal hysterectomy may result in better postoperative sexual function, compared with total hysterectomy. Intercourse is likely to be resumed earlier after subtotal hysterectomy. Neither did they find any significant change of postoperative sexual function, assessed by a condition-specific sexual function questionnaire.

A number of studies compared different types of uterus-sparing surgery with prolapse surgery plus hysterectomy. Sexual function, measured with the FSFI improved in both groups, but greater improvement was observed among women with preserved uterus.

These results should be interpreted with caution because BSO had been performed in the hysterectomy group in addition, which could be an important confounding factor. In summary, sexual function after VH is likely to be unchanged or improved for most women.

Alternative procedures for uterus prolapse, involving uterus-sparing surgery, seem to have comparable outcomes with respect to postoperative sexual function. Studies on hysterectomy and elective bilateral oophorectomy previously have mainly focused on cancer risk reduction and general health issues rather than sexual function. In women requiring hysterectomy for benign disease, preventive removal of the ovaries may be routinely offered to reduce risk of cancer or other adnexal pathology.

Since lifetime risk of 1. Increased perioperative complications, e. Women may be assured that hysterectomy is usually associated with improved quality of life and sexual function, but concomitant oophorectomy has been shown to compromise long-term outcomes depending on the age at which the procedure was performed. Ovarian removal at premenopause had significant negative impact on cardiovascular, cognitive, mental, and psychosexual health [ 36 ].

The resultant estrogen and androgen deficiency leads to more aggravated climacteric symptoms and sexual dysfunctions, e. Sexual infrequency and multiple sexual function problems have also been reported with increased level of menopause symptom intensity when comparing surgical and natural menopause [ 37 ]. Indeed, lower desire, arousal, lubrication, and sexual satisfaction, besides more coital pain, are frequent sexual complaints after perimenopausal oophorectomy.

Estrogen replacement therapy may enhance lubrication and reduce vasomotor symptoms, it may not suffice to improve overall sexual function [ 38 ]. To summarize, combining hysterectomy with bilateral oophorectomy may result in impaired sexual function and increased perioperative and long-term health risks, with benefits only for women at high risk of ovarian cancer. Estrogen replacement may not sufficiently improve sexual function and general health. Individualized risk assessment and information should aid in preoperative decision making.

The Society for Gynecologic Surgeons published a systematic review in , to compare hysterectomy to alternative treatments for abnormal uterine bleeding AUB [ 39 ]. Concerning sexual function, recommendations were weak and no advantage of any of these methods over hysterectomy was found. The authors found a higher crude and adjusted prevalence of psychosexual problems among hysterectomized women; however, non-validated questionnaires were used.

Significantly improved sexual function was only observed after UAE; a validated questionnaire was used. Finally, an interesting study from the USA included 1, premenopausal women presenting with AUB, chronic pelvic pain, or symptomatic leiomyoma and followed them for a mean period of 3. The scores for the pelvic-problem-impact-on-sex scores improved in the long term for all three outcome groups; most improvement was observed after hysterectomy.

In summary, most evidence collected over the past decade show similar improvements in sexual function for alternative treatments to hysterectomy for benign disease. Different options with defined risks and benefits should be discussed with the woman and her preferences considered. Explanations are suggested to be damage to the local autonomous nervous system, resection of the paracolpium, shortening of the vagina, and loss of ovarian function [ 46 ] Individualization adapted to patient and tumor-related factors is the current trend in cervical cancer surgery to minimize therapy-associated morbidity [ 46 ].

As the first choice, it is recommended to preserve nerves with minimum damage, yet without reducing radicality type C , as the second choice to preserve nerves using less radical resection techniques type B [ 46 ].

Nerve-sparing radical hysterectomy has been shown to have less negative effect on sexual function than RH [ 47 ]. Similar, somewhat disappointing results with regard to RVT were confirmed by two other studies [ 49 , 50 ]. Referral for supportive oncosexology care, a new therapeutic offer aiming to improve sexual health of cancer patients may be indicated, although no studies have been published as yet, demonstrating their effectiveness [ 53 , 54 ].

In summary the high proportion of long-time survivors after cervical cancer may benefit from the increased amount of research focusing on less-invasive surgical procedures with potentially less detrimental effect on sexual function for selected patients. Research in this field is hampered by the lack of RCTs. No clear benefit in terms of improved sexual function has been demonstrated for RVT, but seems likely for nerve-sparing techniques and for individualized oncosexology care.

Vaginal blood flow improved and anorgasmia decreased with both forms of ET application, but vaginal dryness and dyspareunia significantly improved only with vaginal ET. Desire or frequency of activity did not improve. Type of ET use was not defined [ 56 ]. Sexual function had been assessed with a validated questionnaire and some women had undergone concomitant BSO.

In summary, ET, in particular vaginal application, is likely to benefit some aspects of sexual function after hysterectomy with BSO. This may also be the case after testosterone treatment, although this should be confirmed by more studies. This complication has been more commonly reported in the last decade, in particular after robot-assisted total hysterectomy. All women had been operated at one institution. Another associated risk factor for vault dehiscence was early resumption of intercourse.

After laparoscopic hysterectomy for benign indication, a risk of 0. A large multicenter study reviewed the charts of nearly 9, women, one third each after abdominal, vaginal, and laparoscopic hysterectomy [ 59 ]. The overall risk for vault dehiscence was 0. Early resumption of intercourse was identified as a risk factor. Women need to be informed about this complication and that abstinence from deep penetration may be advisable for the first 3 postoperative months.

Further evidence confirming this recommendation is needed. During the past decade, there continues to be a lack of research with a focus on partner experience in the context of hysterectomies. This despite the findings of two qualitative studies, one from China, the other from Brazil, that men had considerable concerns about changes in postoperative sexuality or sexual abstinence around the time of hysterectomy of their partner [ 61 , 62 ].

After subtotal hysterectomy, more men noticed during intercourse that the uterus had been removed, but none of these partners experienced this as negative. In summary, for the male partner, sexual function after benign hysterectomy appears to be an important issue and some evidence exists that men can also expect unchanged or improved sexual satisfaction, regardless of removal of the cervix.

Current evidence suggests that hysterectomy for benign disease has beneficial effects on sexual function and general well-being irrespective of the surgical technique used.

Risk factors for postoperative sexual dysfunction are preexistent psychiatric morbidity like depression and unsatisfactory sexual function. Health care providers should inform women accordingly. Hysterectomy indicated by gynecologic malignancy has complex consequences and associated worsening of sexual function.

Lower desire and inadequate lubrication are most persistent. For very-early-stage disease, new techniques to preserve sexual function are promising but more RCTs needed.

There are no official guidelines on when it is safe to have an orgasm, for example, from manual masturbation with the fingers. Gynecology Questions. Sexual Issues. About the Author. Abstract Hysterectomy remains the most common major gynecological surgery. Although a hysterectomy may cause certain changes in the pelvic areas, it usually does not affect the ability to enjoy sex.

Sexual side effects of hysterectomy

Sexual side effects of hysterectomy

Sexual side effects of hysterectomy

Sexual side effects of hysterectomy. related stories

Surgical Complications : Side effects of partial hysterectomy may also include surgical complications like heavy bleeding, pain and infection. Some women may develop internal hemorrhage, blood clots and scar tissues. It has also been noted that in some cases, neighboring structures like the bowel, bladder and the ureters get injured during the surgery.

Cervical Cancer Risk : Though this cannot be considered a side effect, as compared to total hysterectomy wherein both the uterus and cervix are removed , there is a risk of cervical cancer, in case of partial one as the cervix is retained in this procedure.

So, regular pap smear tests are mandatory. Partial hysterectomy is preferred to other types, as the cervix can be retained and so, the risk of complications is lesser. Removal of the cervix may cause vaginal shortening, vaginal vault prolapse, and vaginal cuff granulation, which can be avoided through this surgery. It is also believed that removal of the cervix may affect the sexual life after hysterectomy. Studies show that most of the partial hysterectomy side effects are similar to the side effects caused by other types of uterus removal surgeries.

However, the type of hysterectomy is decided as per the medical condition of the person. Your doctor will decide whether you can retain the cervix, the ovaries or both, on the basis of your medical condition. However, it is the responsibility of the family members to emotionally support women who have undergone hysterectomy, as they may experience both physical and emotional side effects.

It is always better to seek the opinion of health experts, before you decide in favor of hysterectomy in any form. Disclaimer : This article is for informational purposes only and should not be used as a replacement for expert medical advice.

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A small percentage of women experience post hysterectomy pain due to vaginal scar tissue, which may require surgical treatment to be relieved. Shortening of the vaginal canal caused by removal of the cervix can cause difficulty during sexual penetration for some women. Hormone replacement therapy keeps the vaginal skin pliable so that it can stretch to allow for comfortable sexual penetration.

On rare instances, bladder damage occurs during a hysterectomy procedure. Damage results during surgery due to a nick from a surgical tool or by damage to the nerves that affect blood flow to the bladder. Bladder damage can cause difficult urination or incontinence, both of which are usually repaired during a second surgical procedure. Some women experience psychological effects after a hysterectomy.

They may feel that they are no longer a whole or real woman because of the removal of their female organs. A woman also may become depressed because she can no longer bear children, or she may think that menopause equates to being old. It is normal to feel some degree of uncertainty after a medical procedure and during hormonal changes. When feelings of depression or uncertainty interfere with normal daily function and relationships, a woman should seek counseling.

Rose Kivi has been a writer for more than 10 years. She has a background in the nursing field, wildlife rehabilitation and habitat conservation. By: Rose Kivi. Written on: 14 August, More Articles. Home Diseases and Injuries.

References British Medical Journal v. About the Author.

Surgery Can Affect a Woman’s Sex Life

The sexual medicine information session was held the day after our troops went into battle, but people in attendance were totally focussed on Dr. There are 3 types of hysterectomy: partial, where the cervix is left intact, complete, where the cervix is removed the most common procedure and radical, for cancer, where the lymph nodes and supporting structures are also removed.

The uterus can be removed abdominally, vaginally or by LAVH, laparascopically assisted vaginal hysterectomy. If necessary, the ovaries can be removed through the vagina unless there is cancer. Removing the ovaries causes surgical menopause, and women have traditionally been prescribed estrogen therapy, but now there is a fear of this. In the US , hysterectomies are performed annually, triple the rate of the rest of the world.

Before having a hysterectomy, you should find out the reason for it, treatment options, and long term side effects. Side effects of hysterectomy can include depression and loss of sexual response or desire. Most physicians do not think twice about the sexual side effects associated with hysterectomy.

Desire, arousal, orgasm and pain disorders may all be seen post-hysterectomy. Despite this, of the women seen to date at the Center for Sexual Medicine, very few have presented after hysterectomy. Kilkku et al looked at post-hysterectomy patients, and found that among the women who kept their cervix there was no loss in function, but when the cervix was removed, patients complained of sexual dysfunction. Rhodes et al found that post-hysterectomy patients actually had better sexual function.

Even if the woman maintains her ovaries, sometimes the blood supply to the uterus is cut off. Internal orgasms are often changed significantly after hysterectomy. This is observed in part due to the inability to have rhythmic contractions of uterine muscles without the uterus present.

Also internal orgasms are changed after hysterectomy due to injury to the nerves which pass near the cervix. Surgeons should try to spare these nerves, but efforts to spare them are limited at the present. The result is that after hysterectomy, many women lose the ability to have an internal orgasm. Reports suggest that if the uterine cervical ganglia were spared during cervix-sparing hysterectomy, sexual function would be preserved.

The evaluation process for women with sexual dysfunction includes identification of the dysfunction, patient education, modification of reversible factors and first line therapy. The history should include a sexual function history, medical history and psychosocial history.

The examination should include both the vulvar region and an internal physical exam. A sexual medicine doctor is a vulvar specialist, whereas the gynecologist usually examines the region beyond the vulvar area.

Goldstein showed some photographs of women with a normal vulvar region as well as some of pathology. Specialized sexual medicine tests include genital biothesiometry, thermal testing, and duplex doppler ultrasonography. A questionnaire gives the sense of orgasmic function, which can be compared with the results of sensation testing.

Women have limited amounts of sex steroid prior to puberty. Post-puberty if the specific zone of the adrenal gland — the zona reticularis — stops working, you will have sex steroid insufficiency hormonal problems.

As women age the sex steroids stop being synthesized and hormone levels return to those found pre-puberty. Removing the ovaries in animals up regulates estrogen receptors and down regulates androgen receptors. Testosterone in sexually healthy women is higher than in sexually dysfunctional women—suggesting that in some women sexual dysfunction has a biologic basis, a result of enzyme abnormalities, and is not exclusively psychologic.

A study of testosterone treatment after oopherectomy ovaries removed showed that testosterone was beneficial for sexual function. Estrogen therapy or birth control pills send estrogen to the liver that then produces SHBG sex hormone binding globulin which binds with free testosterone. Without this free testosterone available, the woman has androgen insufficiency. The vagina and labia need estrogen to maintain their health, or they become atrophied.

There are estrogen pills that can be put directly into the vagina where the estrogen does not go systemic. It has been shown in animals that Viagra in women increases vaginal blood flow if the hormones are functioning.

In perimenopause you may not have enough progesterone, which causes excessive bleeding, and is a common reason why hysterectomy is performed. Progesterone cream is easy to use. With vacuum clitoris therapy the device suctions the clitoris which increases blood flow into the area. Vulvar surgical intervention may be indicated for pain.

Goldstein showed photographs of some of these surgical procedures. Surgical therapy has been shown to be better than biofeedback or behavioral therapy alone, but since each has benefit, it is best to do all three therapies for women who have sexual pain.

Future Attention should be paid to this—research and funding are needed. Sexual Dysfunction after Hysterectomy Irwin Goldstein, MD The sexual medicine information session was held the day after our troops went into battle, but people in attendance were totally focussed on Dr.

History, Physical and Lab Findings The evaluation process for women with sexual dysfunction includes identification of the dysfunction, patient education, modification of reversible factors and first line therapy. Therapies Utilized Women have limited amounts of sex steroid prior to puberty. Sexual Medicine. Also See. Primary teaching affiliate of BU School of Medicine.

Sexual side effects of hysterectomy

Sexual side effects of hysterectomy

Sexual side effects of hysterectomy