Sexual function after hysterectomy

Sexual function after hysterectomy

Karl E. Miller

Approximately 600,000 hysterectomies are performed in the United States annually, with more than one fourth of them being performed on women younger than 60 years. Hysterectomy is a major surgical procedure with risks and potential long-term consequences. Although almost one half of women who undergo hysterectomy are concerned about postoperative changes in sexual function, few patients discuss these concerns with their physician. The Maryland Women’s Health study found that women who had undergone hysterectomy had an increased frequency of sexual relationships, less dyspareunia, and no change in orgasmic frequency. The study did not explore the patients’ thoughts or concerns of sexual relations after hysterectomy. Dragisic and Milad evaluated sexual function and patients’ expectations of sexual function after hysterectomy.

Enrolled in the study were 75 women at the Prentice Women’s Hospital of Northwestern Memorial Hospital in Chicago who were scheduled for hysterectomy for benign disease between May 2002 and April 2003. During their hospital stay, the women were interviewed by a study researcher. Questions were asked concerning their sexual function, their expectations of sexual function after the procedure, and whether their physician had discussed sexual function after the hysterectomy. The questions concerning sexual function were repeated approximately six months after the procedure.

Before the procedure, 53 percent of the women expected no change in sexual desire, 76 percent expected no change in orgasm frequency, and 67 percent expected no change in orgasm strength. When comparing the answers about sexual functioning at the time of the procedure with the answers six months after the procedure, there were no significant differences between frequency of sexual function or orgasmic response. The women did report a significant reduction in pain with intercourse after hysterectomy, with a relative risk of 5.34. Almost one half of the patients had discussed with their physician the impact that hysterectomy might have on their sexual function, and 65 percent stated that they had initiated the discussion.

The authors conclude that most patients who undergo hysterectomy have no change in sexual desire, orgasm frequency, or orgasm intensity. Patients in the study reported having less pain with intercourse after the procedure.

Dragisic KG, Milad MP. Sexual functioning and patient expectations of sexual functioning after hysterectomy. Am J Obstet Gynecol May 2004;190:1416-8.

COPYRIGHT 2005 American Academy of Family Physicians

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