This article was originally written by James Brann, MD
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Women have mixed emotions regarding the effect of hysterectomy on sexual response and sexual identity. Most woman go on to have a normal sex life, some have a heightened response, while others are less able to have a sexual response following hysterectomy due to their perceived loss of femininity.
Some women may notice a change in their sexual response after the uterus has been removed. For example, uterine contractions a woman might have associated with orgasm may no longer be perceived. Other women may experience a heightened response. This may be due to the fact that they no longer have to worry about getting pregnant and no longer have tremendous pain or dysfunctional bleeding.
If the ovaries are not removed, the outer genitals and the vagina are not affected and remain lubricated when a woman is sexually aroused. If the ovaries are removed at the time of hysterectomy, vaginal dryness may be a problem during sexual intercourse. Vaginal dryness can be helped with the use of estrogen cream.
During a hysterectomy your doctor removes vaginal tissue. This may make the vagina shorter. Deep thrusting during intercourse may be painful. Changing positions during intercourse may help, such as being on top or bringing your legs closer together.
Recently interest in supracervical hysterectomies (where the cervix is not removed at time of hysterectomy) has grown out of speculation that women might enjoy better sexual function after hysterectomy when the cervix is left in place. A new study has found there is no difference in sexual function or quality of life when a supracervical hysterectomy is performed instead of a total abdominal hysterectomy.
Post hysterectomy depression may interfere with sexual response. Depression may follow a hysterectomy from a concept that femininity and an intact functioning uterus are one. Some women link their self-image with reproductive ability. Menses reminds a woman of her uniqueness where hysterectomy takes away this cue. Many women have a brief emotional reaction to the loss of the uterus and ovaries that erodes their sense of well-being and femininity. If the problem persists please discuss your feelings with your doctor.
Be sure if you are considering a hysterectomy you discuss your personal health and medical history with your doctor. He or she will help you decide what procedures are best for you given your personal condition. Many women find this procedure helpful to their overall health and well-being, especially if they are at risk for certain cancers or other debilitating health conditions.