Women who have a hysterectomy often worry about how their sexuality will be affected. But research has shown that having a uterus doesn’t impact sexual function in a permanent way.
Nevertheless, pain during sex isn’t uncommon for women after having a hysterectomy. Here are some reasons why this can happen.
1. Your Body Isn’t Healing Properly
Many women experience an initial loss of sexual desire after a hysterectomy, but this usually returns once they’re fully recovered. The type of hysterectomy that you undergo depends on your medical condition, your plans for a family and other individual factors.
During the surgery, your doctor removes all or part of your uterus, the cervix and often the fallopian tubes as well. In a total hysterectomy, your doctor also removes your ovaries. This will trigger surgical menopause and a drop in estrogen levels, which can cause pain during sex for some women.
Many women report that having a hysterectomy relieves a variety of symptoms that made sex uncomfortable or painful before the operation, including heavy bleeding and pain during intercourse. These positive changes may make sex more pleasurable for many women, even if they’re experiencing pain during sex, which is called dyspareunia. If you have this problem, speak to your doctor about possible causes and treatments. In the meantime, try to relax and take it slowly during sex to avoid irritating the area. Resting and eating a healthy diet can also help you feel better.
2. You’re Experiencing Surgical Menopause
Surgical menopause happens when the surgeon removes your uterus, fallopian tubes, cervix and one or both of your ovaries. This procedure is typically performed for benign reasons like heavy periods and fibroids, or to reduce your risk of ovarian cancer in high-risk women.
When this occurs, your hormones drop dramatically and suddenly, causing symptoms such as hot flashes, night sweats, depression, fatigue, vaginal dryness and low libido to appear. These symptoms are usually more severe than in perimenopause, where the hormones ebb and flow over a longer period of time.
Women who experience this type of menopause can find it very stressful because they have no time to adjust or prepare for the sudden change. They may also suffer from lower bone density, which can lead to osteoporosis and fractures, as well as lower levels of estrogen, which can have a negative impact on their immune system. This can lead to weakened immunity, as well as an increased risk of heart disease and other serious health conditions. For these reasons, it’s important to talk to your doctor about your options and consider getting a second opinion.
3. You’re Having Your Ovaries Removed
During a hysterectomy, doctors may remove your uterus and/or fallopian tubes, which connect to the ovaries. They can also remove your ovaries, which is called an oophorectomy. This surgery is used to treat uterine fibroids, severe pelvic pain caused by endometriosis or a uterine prolapse, and certain types of cancer in the womb and fallopian tubes.
A hysterectomy is usually only recommended when other treatments have failed or you don’t want to have more children. Having your ovaries removed also stops menstruation and reduces your production of hormones.
A hysterectomy is performed in the hospital, where you’ll change into a gown and hook up to monitors. You’ll receive general anesthesia to ensure you don’t feel any pain during the operation. Or, you may get regional anesthesia, which numbs the area around your abdomen or vagina. In some cases, doctors use a minimally invasive procedure with laparoscopy or robotic surgery, which requires fewer surgical cuts. These techniques also reduce recovery time. But, even with these options, you’ll need a lot of rest and will need help at home for the first week or so.
4. You’re Experiencing Other Complications
For some women, having a hysterectomy can cause emotional and psychological issues. Depending on the type of surgery, some women experience bladder problems, loss of sensation in their vagina and a change in menstrual bleeding. If you are experiencing these side effects, talk to your doctor and a mental health therapist about them.
If you had your ovaries removed along with your uterus, this can trigger surgical menopause, which can affect your sexual pleasure and ability to orgasm. Your ovaries produce estrogen, so without them, you can experience a decrease in sexual desire and a dry vaginal canal. Hormone replacement therapy may help, but this is something you should discuss with your doctor first.
Other complications that can occur after a hysterectomy include endometriosis, in which tissue similar to the lining of the uterus grows outside of the uterus on the fallopian tubes and other organs. If this becomes severe, a hysterectomy may be needed to remove the uterus, ovaries and fallopian tubes. Some women also develop a condition called uterine prolapse, in which the uterus falls out of place and causes pelvic pain, urinary leakage and problems with bowel movements.
5. You’re Experiencing Emotional Issues
A hysterectomy can bring a host of emotions, from relief and joy at the elimination of uterine pain to sorrow and loss at not being able to bear children. If your emotional state after surgery is affecting your sexual feelings, it might be helpful to see a sex therapist or counselor for individual therapy sessions.
In addition, many women feel that their clitoris or labia are no longer sensitive after a hysterectomy, even when they are fully healed. Using a good quality lubricant during sex may help alleviate this issue, and some women find that switching up their position or experimenting with different types of sex increases pleasure after surgery.
A hysterectomy is a surgical procedure that removes the uterus, ovaries and fallopian tubes for a variety of reasons including uterine fibroids, endometriosis or cancer. Though many alternatives exist, a hysterectomy is often considered if a woman has exhausted all other options for treating a serious medical condition or has reached an age at which she no longer wants to bear children. Typically, sex does not change significantly after a hysterectomy, except in cases where the position of one’s partner puts pressure over a surgical cut across the belly.
