For some women, sexual satisfaction can improve after a hysterectomy.
Feb. 21, 2000 (San Francisco) -- Janet Harris knew she should have a
hysterectomy. Her doctors told her. Her mother told her. Her friends told her.
But she just couldn't do it.
''I heard the stories about how your sex life is ruined and you go right
into menopause," says Harris, 39, of Baltimore. She put off the surgery for
years until the symptoms from her uterine fibroids got so bad -- aching legs,
constant cramps, menstrual periods lasting 15 or 20 days a month -- that she
had the operation.
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New Study Refutes Older Studies
The reluctance of women to undergo hysterectomy because of worries about a
decrease in their sexual satisfaction isn't unfounded. Studies published in the
British Medical Journal and Obstetrics and Gynecology have
reported that between 13 and 37% of women report deterioration of their sex
lives after hysterectomy.
However a recent study has found that sexual functioning improved overall
after hysterectomy. For two years, researchers from the University of Maryland
tracked sexual function in women at regular intervals after hysterectomy.
"We saw a dramatic reduction in pain during sex," says Julia Rhodes,
M.S., co-author of the study, which was published in the Journal of the
American Medical Association (JAMA) on November 24, 1999.
Two years after the surgery, 76.7% of women were having sexual relations,
compared to 70.5% of women before surgery. The number who reported pain during
sex plunged from 18.6 to 3.6%. Inability to attain orgasm fell from 7.6 to
4.9%. And low libido dropped from 10.4 to 6.2%. In all, 1,101 women between the
ages of 35 to 49 completed the study; 90% had not yet entered menopause.
According to the latest hysterectomy data from the federal Centers for
Disease Control and Prevention (CDC), covering the years 1980 to 1993, women
most likely to have a hysterectomy are between the ages 40 and 44, while 36%
are between the ages of 25 and 39.
A hysterectomy may be done vaginally or abdominally and may include removal
not only of the uterus but also of the cervix and one or both ovaries. Ovary
removal is performed in 51% of hysterectomies and is more likely to be done in
older women and in those whose diagnosis is cancer, according to the CDC. In
the JAMA study, the women had undergone a variety of approaches. Only 15
of the 1,299 women who entered the study had their cervix after the operation,
although the trend now, says Rhodes, is to try to retain the cervix.
It's not known for sure, she says, whether losing the cervix affects
sensation during sex. In their study, the researchers say that external
orgasms, caused by clitoral stimulation, ''are not likely to be affected by
hysterectomy,'' but point to a study published in the Journal of
Reproductive Medicine in 1993, in which the author speculated that removal
of the cervix may hamper internal (vaginal) orgasms.