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Love, sex and hysterectomy

 The very thought of a hysterectomy is almost enough to make your insides shrivel up – especially considering that it does take away most of a woman’s insides. A hysterectomy is a major surgical procedure where the uterus, and sometimes the cervix, fallopian tubes, ovaries or part of the vagina, are removed. No wonder most women fear the thought of undergoing this surgery, as they think that it takes away the essence of womanhood.

Normally, hysterectomies are carried out to treat women with uterine or cervical cancer, or who have a growth in the uterus that can block their bladder or intestines. Other conditions that may call for a hysterectomy are fibroid tumours, severe uterine bleeding, severe infection, pelvic adhesions caused by pelvic inflammatory disease, chronic pelvic pain, uterine prolapse, ovarian cysts, ectopic pregnancy and pre-cancerous cells.

There are several methods of carrying out a hysterectomy. The abdominal hysterectomy involves making a six- to eight-inch incision in your lower abdomen and removing the uterus via that incision. This option requires longer hospitalisation and recovery.

Your surgeon may also suggest other methods, such as vaginal hysterectomy (the uterus is removed through the vagina) or laparoscopic-assisted vaginal hysterectomy (the surgeon inserts a laparoscope to help him view the pelvic organs), which have shorter recovery times. However, the method used depends on your condition, your medical history and the surgeon’s skills or preference.

Needless to say, a woman will think long and hard before choosing to have a hysterectomy. The number one fear on her mind will probably be sexual problems. Some changes to sexual functioning are bound to be expected. Some women will find that they miss the contractions of the uterus they have associated with orgasm. The physical sensation of deep penetration during intercourse will be different if the cervix has been removed.

If a woman undergoes a hysterectomy that removes her ovaries as well, she will experience hormone changes due to less production of sex hormones. However, this can be overcome if she starts on hormone replacement therapy after surgery. But these changes do not mean the end of a sex life. Although many women are afraid that they will lose their desire for sex or that sex will become painful and unpleasurable after a hysterectomy, there is good news.

Hope after a hysterectomy

About 1,300 women who took part in a 1999 study by the University of Maryland Medical School can assure you that having a hysterectomy is not the end of your sex life. The study assessed how the women’s sex lives had been affected by their hysterectomies. They were interviewed for up to two years after their surgery, answering questions about how frequently they experienced pain, orgasm or vaginal dryness during sexual intercourse, and how often they desired sex.

Not only did the women say that they were having sex more often, they also reported having better sex, stronger and more frequent orgasms, and less pain during intercourse. Why would sex be better after such major surgery? Think about it: if you had serious gynaecological problems, such as severe bleeding, tumours or growths, wouldn’t you feel better after these had been relieved by hysterectomy?

Similarly, in the study, the women no longer experienced pain, discomfort or bleeding caused by their problems, and did not have to worry about birth control. So it was not surprising to find that their interest in sex was restored. Better sex is not a miracle, however. Good outcomes are more likely if the woman has a satisfying relationship with her sexual partner, has not been diagnosed with depression and is properly counselled before and after surgery about what to expect.

One step at a time

All this good news does not mean that you should return to a vigorous sex life immediately after surgery! Your body has been through a bit of trauma and needs some time to recover. You are bound to experience some post-operative symptoms up to two weeks after the surgery, such as pain and itching at the site of surgery, vaginal problems, gastrointestinal problems and fatigue. These may make you feel a little unwell, but only temporarily.

You should wait for at least four to six weeks (or on the advice of your surgeon) before attempting vaginal (penetrative) sex. However, this doesn’t mean that you and your partner can’t indulge in romance and affection, by hugging, touching or kissing each other.

It is believed that some women may suffer from depression after a hysterectomy. However, don’t assume that this will definitely happen to you. Women who are at risk of developing depression are those who have existing psychological problems, those who do not find symptom relief from the surgery, those who develop serious post-surgery complications or side effects, and those who have been rushed into the procedure without coming to terms with it.

Depression can cause low libido and decreased interest in all activities, including sex. If you experience these feelings for a prolonged period of time, talk to your doctor or a professional therapist. In fact, you should discuss any concerns or questions with your doctor before you make the decision to have a hysterectomy, and also after the surgery. The most important thing is to experience this with your partner by your side, so that he understands the changes that you may go through and can help meet your needs.

Star newspape. Jul 20, 2007
By Datuk Dr Nor Ashikin Mokhtar