Sex after hysterectomy

• Many patients who require removal of their uterus for one reason or another often have insecurities as to whether or not this operation will affect their sex life.
• Many of the beliefs about what will happen to a woman's sex life after a hysterectomy are simply myths that need to be debunked.
• Performing a hysterectomy on a patient will improve her sex life with respect to the pain and discomfort she previously suffered, as well as improving her life on an emotional level.

Hysterectomy is an operation in which the woman's uterus is removed and, in some cases, in addition to the uterus, the cervix and even other structures or organs close to the uterus may also be removed.

The need to remove the uterus may arise because the patient has uterine cancer or uterine fibroids, or any other type of pathology that requires it.

Sometimes it is necessary for the surgeon to remove the patient's ovaries if required, although when the woman is under 40 years of age, removal of both ovaries is avoided and only one is left. 

This single ovary will be able to produce enough hormones to prevent the patient from having a premature menopause.

Due to the removal of the uterus by hysterectomy, the woman must be aware that she will no longer be able to become pregnant or have menstrual periods.

We can differentiate between four types of hysterectomy, depending on which parts are removed from the patient:

• Total abdominal hysterectomy: consists of removing both the uterus and the cervix.
• Subtotal abdominal hysterectomy: only the uterus is removed.
• Radical abdominal hysterectomy: involves removing the uterus, the cervix, the uppermost part of the vagina and all surrounding lymph nodes and ducts.
• Total hysterectomy plus double adnexectomy: consists of removing all of the above plus both fallopian tubes.

Commonly, before undergoing a hysterectomy, women are concerned about the possible consequences of hysterectomy. 

The most common concern is often about losing sexual pleasure with a partner. 

This concern is based on the belief or myth that removing the patient's uterus will leave this part of her body empty and unresponsive.

When a woman suffers from any of the symptoms derived from uterine pathology, such as uterine fibroids, etc. 

Her sexual life is greatly affected due to these discomforts and, in addition, due to the emotional burden suffered by the patient, which also alters her sexual desire.

Loss of sexual desire can also be caused by the irritability felt by the patient and the necessary medical care, which focuses all attention on avoiding pain and discomfort and puts sexual intercourse on the back burner.

As we have already mentioned, there are many myths surrounding hysterectomy surgery and sexual relations, however, some experts point out that sexual encounters of the couple improve significantly after a hysterectomy. Basically with regard to the sexual situation before the surgery.

Performing a hysterectomy improves the patient's quality of life, as it eliminates pain and other conditions that prevent a normal sex life.

The main cause of hysterectomy is pain and discomfort caused by health problems such as those we have already mentioned (uterine cancer, uterine fibroids, etc.), so when the source of the pain and discomfort is eliminated, relations improve and return to the way they were before the pathology that indicated the hysterectomy.

It is also true that the patient must wait for the wound to heal completely before having sexual intercourse (usually 5 to 7 weeks), otherwise there could be wound complications such as infection.

As for the removal of the patient's ovaries in cases where this is necessary, the hormonal production of oestrogen would be altered, which could cause vaginal dryness, hot flashes, decreased sexual desire, etc. However, this can be properly treated by hormone therapy, so it would not be a problem for the woman.

Some women sometimes feel a sense of "emptiness", "incompleteness" or even feel less feminine after having a hysterectomy. As a result of this attitude on the part of the woman, they may experience depression or a refusal to have sexual relations.

It should be clear to them that the purpose of the hysterectomy is to improve their quality of life and eliminate symptoms and discomfort, so they should not have to worry and should be sure that they want to undergo the operation, otherwise they may show the insecurities already mentioned.

After undergoing a hysterectomy and after the postoperative period, the man will not notice any difference in sexual intercourse compared to before the patient underwent surgery.

The sexual life of the couple will not be affected, at least not negatively. Some women may experience an increase in libido and orgasms, which may be due to the fact that, after hysterectomy, the woman's sensory threshold will increase, which may make it easier for her to reach orgasms.

Sometimes (and always in consultation with the patient), surgeons use the hysterectomy as an opportunity to reconstruct the vaginal canal and narrow it. If the vaginal canal is narrowed, the man will have a more pleasurable sensation during intercourse.

It is essential that both the woman who is going to undergo hysterectomy and her partner know the benefits and disadvantages of hysterectomy and that they are well informed by the gynaecological specialist about what it entails in order to avoid misunderstandings and false myths.

In conclusion, we can say that the hysterectomy operation has no negative consequences in terms of sexual relations with a partner. The only direct consequence is that the woman's reproductive capacity will be completely lost, as we have already said.