Sex After a Hysterectomy
Elizabeth Rattray had only been married for a few years when she found out she needed a hysterectomy (removal of the uterus) to relieve severe pain from fibroids. ''I kept thinking, 'This is going to be a nightmare,' and it really blew my mind,'' says Rattray, a Cleveland-based Medicare-accredited insurance broker.
Her uterine fibroids had caused her uterus to expand to ''the size of a five-month pregnancy,'' Rattray recalls. She began to worry about the impact on her health of losing her uterus, her inability to have children, and how her surgery would affect her ability to have sex with her new husband. Her couple were in their early 30s. Rattray researched and obtained several medical opinions. She says doctors suggested surgery to remove the ovaries along with the uterus.
At the urging of a trusted friend, Rattray and her husband eventually moved from Cleveland to Atlanta to have a laparoscopic hysterectomy. The surgeon of her choice agreed that she could keep her ovaries, so she did. The surgery and recovery went well. Rattray says her sex life has never been better. ''Everything works, everything is fine,'' she says.
How long to wait
Sex after a hysterectomy is a major concern for many women considering surgery, but it doesn't have to be, says Maureen Whelihan, M.D., an obstetrician and gynecologist in Palm Beach County, Florida.
''After a hysterectomy, you can have sex at any time, including sexual stimulation, orgasm, and manual stimulation,'' says Wellihan. You have to give him time before you have vaginal penetration sex. ''We recommend waiting about four weeks for the upper part of the vagina to heal,'' Whelihan says, ''for very complicated surgeries, the doctor may tell her to wait six weeks.''
''Just to be clear, there are many other methods for sexual gratification and release that don't require penetration,'' she adds.
After the healing period, women shouldn't feel pain during sex after a hysterectomy, says Whelihan.
Get answers to questions
As with any medical treatment, it's best to know your options, pros and cons, and preferences.
Get her second opinion and third opinion if you want, she says Francesca M. Rogers, M.D., Obstetrician and Gynecologist at Women's Care, Pavilion, Burbank, CA.
That means asking important questions, such as whether the ovaries really need to be removed. It used to be common practice, Willihan notes. But it is not necessary. So if it's recommended, check why. Libido
Having your uterus removed will not affect your desires. However, it can occur if the ovaries are removed as well as the uterus.
''Sexual dysfunction is caused by loss of ovaries,'' says Whelihan. A hormone that produces ovaries. ''The problem wasn't the hysterectomy,'' he says, Whelihan.
If the ovaries need to be removed along with the uterus, hormone replacement therapy can safely replace some of the lost hormones and may also help reduce the risk of cardiovascular problems associated with estrogen loss. For most premenopausal women, libido does not change when HRT is started at the time of surgery.
Many things affect a woman's libido, including stress, relationship problems, and other health issues. If sex still doesn't meet your expectations, remember that it may not be a physical problem. She estimates that about a third of patients with low libido ''have underlying anxiety or depression that is not adequately managed.'' Treating these other conditions can help libido.
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