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Did you know that hysterectomy can kill your joy of sex? By Lise Cloutier-Steele Though hardly an excuse, part of the reason why post hysterectomy sexual dysfunction is rarely discussed prior to surgery is because gynecologists are not taught much about women’s sexual health in medical school. But sexual dysfunction following a hysterectomy and ovary removal procedure can be a devastating outcome for many, which is why women should proceed with caution if a hysterectomy has been prescribed for a non cancerous indication. Insist on hanging on to your cervix! From my interviews with gynecologists, I learned that there are many good reasons for retaining the cervix. It helps to support the pelvic floor structures; for example, it will help prevent the bladder from prolapsing, or becoming displaced and/or distended. It can act as a barrier for infection and provides some vaginal lubrication. If a woman retains her cervix, her vaginal integrity is more likely to remain stable. What if your vagina was made shorter? The American College of Obstetricians and Gynecologists admits to vaginal shortening at hysterectomy in its 1999 pamphlet Understanding Hysterectomy. It states clearly that if the hysterectomy procedure requires vaginal shortening, concurrent with the removal of the cervix, deep thrusting with intercourse may become painful. I was thrilled to see this information finally made public until I read the recommendations. There were two: 1) Being on top during sex or 2) bringing your legs closer together may help. Any woman will tell you that intercourse wouldn’t be pleasurable, if at all possible, if she had to keep her legs closer together, and women living with the condition of a shortened vagina will tell you that attempting the “on top” position would be excruciatingly painful. To this day, some gynecologists still dismiss this complaint by saying that the shortened vagina syndrome is a problem that will resolve itself because vaginal tissue stretches. But scar tissue does not, and if you're left with too much of it at the top of the vagina, sex won't ever be the same. Can you live with diminished orgasmic responses? Dull orgasmic responses are often the result of nerve damage caused by the cutting with surgical instruments around the organs being removed (uterus, cervix, Fallopian tubes and ovaries). Without a cervix or a uterus, it is impossible for any hysterectomized woman to have a deep uterine orgasm. In order to achieve one, the penis must make contact with the cervix (the correct medical term is cervical tapping), causing the cervix to jiggle a little, which, in turn, causes the uterus to contract. That’s what is known as “the big O” and many women don’t realize that this pleasure won’t ever be a part of their sexuality after their reproductive organs have been excised from their abdomen. As for the clitoral orgasm, it too can be diminished. There are a lot of nerves extending from the uterus and the cervix to the clitoris, and once these are cut to remove the cervix, the clitoral orgasm can become very dull. Your libido could also take a nosedive Loss of sexual desire is another form of sexual dysfunction, which is the direct result of oophorectomy (removal of the ovaries). You’ll always remember what it was like to look at your partner with desire, but once the ovaries are gone, it’s hard for most hysterectomized women to will their bodies to desire sex. This is a problem that is getting lots of attention lately and some medical experts are now specializing in the treatment of female sexual dysfunction (FSD). The problem is that their services are aimed mostly at women who still have their reproductive organs, excluding oophorectomized women who probably need their help the most. If you’ve been prescribed a hysterectomy for an indication other than cancer, and if your sexuality is important to you and your partner, find a compassionate gynecological surgeon who specializes in minimally invasive alternatives to hysterectomy. You’ll be glad you did.
read another article by Lise Cloutier-Steele Surviving without HRT - with No Ovaries
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