Sexual Health after Hysterectomy

Hysterectomy, the surgical removal of the uterus, is one of the most common surgeries performed on women, second only to C-sections. While it can be life-changing for women dealing with chronic pain, heavy bleeding, fibroids, or even cancer, many patients wonder how it might impact their sexual health. Today, we’ll explore what a hysterectomy involves, the different types, and how it can affect intimacy and overall well-being.

Different Types of Hysterectomy

There’s often confusion around the term "hysterectomy." Many women refer to having a “complete” or “partial” hysterectomy without fully knowing what these terms entail. Here’s a breakdown:

• Total Hysterectomy: This removes the uterus and cervix but leaves the ovaries and fallopian tubes. In medical terms, this is typically referred to as a complete hysterectomy.

• Subtotal or Supracervical Hysterectomy: This removes only the upper part of the uterus, leaving the cervix intact.

• Hysterectomy with Bilateral Salpingo-Oophorectomy: This includes removal of the uterus, cervix, fallopian tubes, and both ovaries. This option is common for women at risk of ovarian cancer.

If you’re uncertain about what type of hysterectomy you’ve had or are considering, ask your doctor to explain which organs will be removed and why.

Why Women Choose Hysterectomy

The primary reasons for undergoing a hysterectomy include:

• Chronic pelvic pain

• Fibroids or benign tumors

• Heavy or irregular bleeding

• Endometriosis

• Cancer of the uterus, cervix, or ovaries

For many women, the procedure provides substantial relief from these conditions, significantly improving quality of life.

How a Hysterectomy Affects Sexual Health

In most cases, a hysterectomy doesn’t negatively impact sexual function. Since the primary source of orgasm for most women is clitoral stimulation, which isn’t affected by a hysterectomy, sexual enjoyment typically remains intact. In fact, many women report an improvement in sexual experiences post-surgery because it resolves pain and discomfort associated with their previous condition.

However, the procedure can affect sexual health in some specific cases:

• Removal of the Cervix: Some women experience a type of orgasm triggered by cervical stimulation. For these women, a hysterectomy that removes the cervix may impact their ability to have cervical orgasms.

• Uterine Removal: Some women report a sensation of fullness or pleasure from uterine movement during intercourse. While not common, this feeling may be missed after the uterus is removed.

For most women, removing the uterus and/or cervix has no major impact on sexual satisfaction. Discussing these possibilities with your doctor before surgery can help manage expectations.

What about the Fallopian Tubes and Ovaries?

The impact of a hysterectomy on sexual health depends on whether the ovaries and fallopian tubes are removed:

• Fallopian Tubes: Fallopian tubes don’t produce hormones and have no direct impact on sexual health. However, recent research suggests that removing the fallopian tubes (salpingectomy) during a hysterectomy may reduce the risk of ovarian cancer.

• Ovaries: The ovaries are the primary source of estrogen, progesterone, and testosterone in women. Removing them can trigger early menopause, which may affect libido, arousal, and vaginal lubrication. If ovarian removal is necessary, hormone replacement therapy (HRT) may be an option to manage these changes.

Different Approaches to Hysterectomy

How a hysterectomy is performed also influences recovery time and potential complications:

• Abdominal Hysterectomy: This involves a large incision across the abdomen and is typically used when the uterus is large or cancer is involved. It requires the longest recovery period and may involve more postoperative discomfort.

• Vaginal Hysterectomy: This is performed through the vagina, leaving no visible scars on the abdomen. It has a shorter recovery period and fewer complications, but it may not be suitable for all patients.

• Laparoscopic or Robotic Hysterectomy: These minimally invasive procedures use small abdominal incisions and advanced tools. Robotic surgery gives the surgeon greater precision, which may reduce postoperative pain and recovery time.

If you’re considering a hysterectomy, discuss these options with your surgeon to determine which approach is best for you.

Radical Hysterectomy and Sexual Function

Women with cervical cancer may undergo a radical hysterectomy, which removes the uterus, cervix, and surrounding tissues, sometimes including parts of the vagina. This type of hysterectomy can shorten the vaginal canal, which may lead to discomfort or pain during intercourse. Devices like O-nut rings (worn at the base of the penis to limit penetration depth) can help make intimacy more comfortable.

Post-Hysterectomy Health Concerns

While a hysterectomy can bring relief, there are some potential long-term effects to be aware of:

• Pelvic Floor Health: Removing the uterus doesn’t cause pelvic organ prolapse, but pelvic floor support is essential post-surgery. Maintaining pelvic floor muscle strength through exercises or therapy can prevent future issues.

• Pelvic Pain: Occasionally, women experience new pain due to scar tissue or pelvic floor muscle spasm after a hysterectomy. A pelvic exam can identify and treat these issues.

• Ongoing Pelvic Exams: Even without a uterus or cervix, women should still have annual pelvic exams to screen for conditions of the vagina, vulva, and other pelvic structures.

Addressing Emotional Concerns

For some women, a hysterectomy can feel like a loss of femininity. If you’re feeling uncertain, speak openly with your doctor about your concerns. Many non-surgical options are available, so exploring alternatives with your physician can help ensure you feel comfortable with your decision.

A hysterectomy is a highly personal decision with both physical and emotional implications. Discussing your specific health concerns and sexual health goals with your doctor will help you make the choice that’s best for you. If you’re considering a hysterectomy, don’t hesitate to ask your surgeon about post-surgical outcomes, recovery expectations, and potential effects on intimacy.

Listen to Dr Jackson go into detail about this topic!  You can hear the full episode on her podcast, Ageless and Outrageous.  Be sure to like and follow so you don’t miss an episode!

https://agelessandoutrageous.alitu.com/

The team at Foundations at Maitland are all vaginal and sexual health experts who have been helping men and women have a more fulfilling and intimate sex life for over 20 years.  If you are considering vaginal rejuvenation, you deserve to only see an expert. 

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FOUNDATIONS AT MAITLAND

At Foundations at Maitland, in Maitland FL, we offer a full range of non-surgical treatments to help you reach your aesthetic, wellness, and sexual goals.  Our providers are highly trained and experienced.  We are led by our double-board certified surgeon, Dr Kristin Jackson, who has personally developed all treatment protocols and is closely involved in the day-to-day operations of our medical spa.  With her extensive training in all non-surgical cosmetic treatments as well as over 20 years of surgical experience, Dr Jackson is uniquely qualified to ensure our medical spa provides you with the highest standards of quality care and safety.

If you are looking for vaginal rejuvenation doctors near you, we can help!  Contact us today for your complimentary consultation!