Nov. 23, 1999 (New York) -- Many women experience improvements in sexual functioning as a result of having a hysterectomy, a large study in the November 24th issue of the Journal of the American Medical Association finds. Benefits of the surgery include increased frequency of sexual relations, increased desire for sex, and a decrease in painful or uncomfortable intercourse.
Researchers led by Julia C. Rhodes, MS, of the department of epidemiology and preventive medicine at the University of Maryland in Baltimore, suggest that in addition to improvements resulting from the removal of the unhealthy uterus, women may also have an improved quality of life following hysterectomy that translates to a better sex life. Freedom from vaginal bleeding as well as from fear of pregnancy also may play a role.
"There's a perception in the general public that sexual function is impaired by hysterectomy," Rhodes tells WebMD. "But if you actually look at the scientific literature, many of the previous studies agree with our findings that sexual functioning actually improves after hysterectomy."
The 1,299 women participating in the Maryland Women's Health Study were interviewed prior to hysterectomy and at three, six, 12, 18, and 24 months after surgery. In all cases, hysterectomy was indicated for benign conditions. During the interviews, women were asked about frequency of sexual relations in the past month, frequency of pain during sexual relations, frequency and intensity of orgasms, incidence of vaginal dryness, and desire for sex. Most participants were between the ages of 35 and 49, were white, and were either married or living with a partner.
Overall, the frequency of sexual relations increased from twice a month before hysterectomy to approximately three times per month at both 12 and 24 months after the hysterectomy. Prior to hysterectomy, the incidence of painful or uncomfortable intercourse was 41%. At 12 and 24 months after hysterectomy, this percentage dropped dramatically to almost 20% and almost 15%, respectively. Frequency of orgasm also increased from about 63% prior to hysterectomy to about 72% at both 12 and 24 months afterwards. Likewise, strength of orgasm rose from 45% of women experiencing strong orgasms before hysterectomy to almost 60% and over 57% reporting strong orgasms at 12 and 24 months.
Approximately 37% of women reported no vaginal dryness prior to hysterectomy. At 12 and 24 months posthysterectomy, approximately 47% reported no vaginal dryness. However, 9% of women who did not have vaginal dryness before hysterectomy reported this problem after surgery and 35% of women with vaginal dryness before hysterectomy reported persistence of the problem. Use of hormone replacement therapy or lubricants can alleviate vaginal dryness and should be discussed with patients prior to hysterectomy so they can be prepared should vaginal dryness develop, the researchers say.
Frequency of sexual desire increased significantly, with more than 70% of women who reported low libido before hysterectomy reporting an increase in desire at 12 months. Very few women with normal libido before hysterectomy reported a decreased desire for sex. Of 325 women who reported no sexual activity prior to hysterectomy, over 140 were sexually active in the months prior to the 12-month interview and almost 150 were sexually active in the months prior to the 24-month interview.
Rhodes says the findings will not be a surprise to physicians who perform hysterectomies because most have known for years that the majority of women have good outcomes in terms of sexual functioning. "One of the things this study can be used for is to help many of those physicians reassure their patients by showing that indeed, this large group of women did feel better after hysterectomy," she says.
Another significant finding was that women who were depressed prior to having a hysterectomy had less improvements in sexual functioning than nondepressed women. Rhodes and colleagues suggest future research should examine whether giving antidepressants prior to hysterectomy improves symptoms as well as sexual outcomes.
- After having a hysterectomy, many women experience an improvement in sexual functioning, including increased frequency of sex, increased desire, and a decrease in painful or uncomfortable intercourse.
- There is a general perception that a hysterectomy may actually impair sexual function, but now physicians have scientific data to reassure patients that this is not the case.
- Women who were depressed prior to hysterectomy showed less improvement than those who were not depressed.