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What effect does a hysterectomy have on sexual function?

A hysterectomy will not affect sex drive. Women with pelvic pain may even have improved sex lives following their hysterectomy.

A hysterectomy doesn’t always hurt a patient's sex life, but it can reduce libido in some. It does take some time for the vaginal wall to heal resuming sexual activity.

Virtually every woman expresses concerns, if not to her doctor, to her partner, or even herself about how hysterectomy will affect her sexual function, desire and desirability. Unfortunately, studies have shown that only half of gynecologists initiate a discussion of sex and few patients are brave enough to bring it up themselves. That means a lot of women who worry about their postoperative sexuality do just that—worry.

But, there is good news. Studies (and a survey I did of my patients!) consistently show that the most important thing that determines what sex after hysterectomy is like, is what sex before hysterectomy was like.

The decline in libido, and/or vaginal lubrication, that some women experience after hysterectomy occurs from the loss of ovaries, not the loss of the uterus. In other words, if you don’t go into menopause as a result of your hysterectomy, nothing should change.

In the spirit of full disclosure, the occasional woman, even if she keeps her ovaries, says that things seem different, her orgasms less intense. Most women have orgasms that are clitoral and vaginal in nature, but some women are aware of uterine contractions when they climax. If the uterus is gone, that aspect of their orgasm will also disappear.

Dr. Elizabeth A. Poynor, MD
Gynecologic Oncologist

A hysterectomy doesn't cause any physical changes that would change a woman's sexual functioning, and for most, having a hysterectomy doesn't negatively impact their sex life, says Elizabeth Poynor, MD, PhD, a gynecologist-oncologist in New York.

Dr. Bonnie Lynn Wright, PhD
Geriatrics Nursing Specialist

Hysterectomy with and without removal of ovaries most often has a negative impact on sexual function because of changes in hormone levels. This is in part due to the surgical removal of these hormone-producing organs. Hormone replacement therapy is sometimes recommended by the doctor to off-set these changes.

Psychologically, if producing children has been a key element in the woman's self-image, a hysterectomy will be a huge challenge post-surgery. This internal conflict may reduce sexual desire.

However, for women who see themselves as more than baby-makers, sexual desire will diminish less. Also, women for whom a change in sexual desire in the short term is not overwhelming, will be able to maintain a healthy sex life.

Women who will be delighted not to have to risk pregnancy anymore may in fact experience an increase in libido in spite of hormone fluctuations.

Just remember your brain, not your uterus, is your most powerful sexual organ.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.