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Hysterectomy Doesn't Diminish Sexual Pleasure

For many women, sex is more enjoyable after the operation, study says

THURSDAY, Oct. 2, 2003 (HealthDayNews) -- Contrary to what women may fear, having a hysterectomy doesn't decrease sexual pleasure. In fact, new research says the procedure is more likely to increase enjoyment of sex for many women.

"If you take away the factors [that indicate the need for a hysterectomy], sexual well-being may improve also," says Dr. Jan-Paul Roovers, lead author of a study in this week's issue of the British Medical Journal.

In other words, the problems that call for a hysterectomy can also compromise a woman's enjoyment of sex.

"What [this study] is basically telling you is that when you remove the underlying symptoms of why the woman had to have the hysterectomy, she feels better," adds Dr. Stephen R. Goldstein, a professor of obstetrics and gynecology at New York University School of Medicine.

Roovers adds, however, that "sexual problems should never be a reason to perform a hysterectomy."

According to the researchers, hysterectomy is the most common major gynecological operation in the United States and the United Kingdom. And almost one-third of women in the Netherlands, where the study was conducted, will need a hysterectomy during their lifetime.

There has been some concern that because hysterectomy effects the arrangement of pelvic organs and can disrupt local nerve supply, that it might also effect sexual pleasure.

There has also been speculation that a hysterectomy's effects may differ, depending on the type of procedure. The authors of this study looked at three types of hysterectomy: vaginal hysterectomy, total abdominal hysterectomy and subtotal abdominal hysterectomy.

Previous researchers had thought that vaginal hysterectomy, which involves removing the cervix and the uterus through the vagina, might damage the vagina. A subtotal abdominal hysterectomy was supposed to be the best for sexuality.

A total abdominal hysterectomy involves removing both the cervix and uterus via an abdominal incision, while a subtotal abdominal hysterectomy involves removing the uterus but not the cervix, again through a cut in the abdomen.

After studying 413 women at 13 hospitals in the Netherlands, the study authors found the type of hysterectomy had no impact on sexual well-being after the procedure.

Sexual pleasure improved in all the patients, regardless of the type of procedure they underwent. Women were asked to assign a number from one to 10 to describe their sexual well-being before the surgery.

"On average, they gained half a point," Roovers says. "It was not different among the procedures."

The final conclusions were based on 352 women with male partners who had responded to a questionnaire six months after surgery. Frequency of intercourse was similar both before and after hysterectomy for all the women. The authors excluded women who had undergone the operation for prolapse (when the uterus tilts or slips) or for endometriosis (when the lining of the uterus is found outside the uterus).

Women who had undergone one of the abdominal procedures had an increased but not statistically significant problem with lubrication, as well as arousal and sensation in the genitals.

Of the 173 participants who reported one or more sexual problems before the hysterectomy, 29 still reported the problems after vaginal hysterectomy, 23 after subtotal abdominal hysterectomy and 45 after total abdominal hysterectomy, the researchers say. New sexual problems developed in nine patients after vaginal hysterectomy, in eight patients in the subtotal abdominal group and in 12 patients in the total abdominal group.

The findings give women deciding whether or not to get a hysterectomy one more dimension to consider.

"All this article does is help us understand if you have a good reason to have a hysterectomy, fear about its effect on sexual function should not persuade you or dissuade you," Goldstein says.

Adds Roovers, "In the Netherlands we are not very fast to propose hysterectomy. This is relevant to women who have already explored other options."

More information

For more on the different types of hysterectomy, visit the National Women's Health Information Center or the American College of Surgeons.

SOURCES: Jan-Paul Roovers, M.D., Ph.D., registrar, department of obstetrics and gynecology, University Medical Center, Utrecht, the Netherlands; Steven R. Goldstein, M.D., professor, obstetrics and gynecology, New York University School of Medicine, New York City; Oct. 4, 2003, British Medical Journal
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