Sex After Hysterectomy.

Women Report Problems But Most Improve

From the WebMD Archives

Nov. 17, 2003 - Women with cervical cancer commonly report problems with sex after hysterectomy, a new study shows. But there is some good news.

Researcher Pernille T. Jensen, MD, of Denmark's Bispebjerg Hospital tells WebMD that there is little information about the impact of on sex after hysterectomy in women with early-stage cervical cancers.

"These women tend to be younger than other cancer patients, so sexual function is an important issue," she says.

Sex After Hysterectomy: Problems Don't Last

Jensen and colleagues followed 173 women with early-stage cervical cancer for two years after the women underwent radical hysterectomies -- where the uterus and surrounding tissue, including a small part of the vagina are removed. This is a common first-line treatment for early and advanced forms of cervical cancer.

Six times over a two-year period, the women completed standardized questionnaires to assess any problems with sex after hysterectomy. The responses were compared with a comparison group of women without cancer who were of similar age.

Five weeks after surgery, 67% of the women with cervical cancer reported having trouble reaching orgasm, compared to 33% of the comparison group. But two years after surgery, orgasm difficulties in the women who underwent hysterectomy had significantly improved -- with 36% reporting orgasm difficulties.

Interest in sex also improved. Five weeks after hysterectomy, 77% of the women reported little or no interest in sex, but that dropped to 57% two years after surgery. Just under half of the comparison group reported little or no interest in sex.

Two years after surgery, women continued to report more lubrication problems during sex, but the overall numbers were relatively small -- 10% of patients and 3% of the comparison group reported this problem. The findings are scheduled for publication in the Jan. 1, 2004 issue of the American Cancer Society publication Cancer.

"We found that most, but not all, sexual problems resolved within three to six months of surgery," Jensen says. "Even though this is the case, it is important to warn women facing this surgery about this risk. For the most part, this isn't happening right now."


Fewer Problems Than With Radiation

In an earlier study, Jensen and colleagues found a high frequency of sexual problems in women with advanced cervical cancer treated with radiation. While the researcher says the two patient populations cannot be compared, she says that radical hysterectomy is associated with fewer sexual side effects than radiation.

Gynecological cancer expert Debbie Saslow, PhD tells WebMD that it is unclear from the Danish study if the problems reported by the women with cervical cancer were caused by the surgery itself or by the psychological impact of having cancer. Saslow is director of breast and gynecologic cancer for the American Cancer Society.

"Most of the problems reported in this study seemed very short term," she says. "I think it would be normal for a woman who is dealing with a diagnosis of cancer to experience a decrease in sexual interest or satisfaction, regardless of the treatment. But that doesn't mean that a cervical cancer patient should ignore these problems or should not discuss them with her doctor if they occur."

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SOURCES: Pernille, J. Cancer, Jan. 1, 2004; vol. 100: pp. 1-10. Pernille T. Jensen, MD, department, palliative medicine, the research unit, H.S. Bispebjerg Hospital, Copenhagen, Denmark. Debbie Saslow, PhD, director, breast and gynecologic cancer, American Cancer Society.
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