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For many women, sexual functioning improves after hysterectomy

Every year more than a half million U.S. women undergo hysterectomy to treat chronic gynecologic problems. The most common concern among these women is the negative impact of a hysterectomy on their sexual functioning. The findings from a recent study may relieve their anxiety. It shows that many women had overall improved sexual functioning after hysterectomy, ranging from more frequent and more satisfying sexual relations to less vaginal dryness and painful intercourse. The 2-year Maryland Women's Health Study was led by Kristen H. Kjerulff, Ph.D., of the University of Maryland Baltimore County, and supported by the Agency for Healthcare Research and Quality (HS06865).

Dr. Kjerulff and her colleagues interviewed 1,101 women (aged 35 to 49 years) about their sexual functioning prior to hysterectomy and again at 6, 12, 18, and 24 months after surgery. The percentage of women who had engaged in sexual relations in the prior month increased significantly from 71 percent before hysterectomy to 77-78 percent 1 and 2 years after the operation. The rate of frequent dyspareunia (painful intercourse) dropped from 19 percent before hysterectomy to 4 percent 1 and 2 years later. The percentage of women experiencing orgasms increased from 63 percent before hysterectomy to 72 percent 1 and 2 years later. Low libido rates (desiring sexual relations less than once a month) also decreased significantly from 10 percent prior to the operation to 6 percent 1 and 2 years after it. Finally, those who did not experience vaginal dryness (which can cause pain during intercourse) rose from 37 percent before surgery to 47 percent afterwards.

These findings included adjustment for menopausal status before surgery and posthysterectomy use of hormone replacement therapy. The researchers note that relief from symptoms such as pelvic pain and painful intercourse may have led to increased sexual enjoyment and increased orgasm frequency. This symptom relief also may have outweighed any lost sensation due to removal of the cervix. Freedom from vaginal bleeding and fear of pregnancy could account for some of the observed improvements.

See "Hysterectomy and sexual functioning," by Julia C. Rhodes, M.S., Dr. Kjerulff, Patricia W. Langenberg, Ph.D., and Gay M. Guzinski, M.D., in the November 24, 1999, Journal of the American Medical Association 282(20), pp. 1934-1941.

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