Sexual relations improve after hysterectomy says University of Maryland School of Medicine study

December 06, 1999

In the largest study of its kind ever conducted, researchers at the University of Maryland School of Medicine have concluded that contrary to popular belief, the sex life of most women improves dramatically following hysterectomy. Along with an increased desire for sex, women had sex more often, had stronger and more frequent orgasms, and experienced less pain during intercourse. The study is being published in the November 24th issue of the Journal of the American Medical Association (JAMA).

Thirteen hundred Maryland women from all walks of life were interviewed during the two-year study. All had hysterectomies to treat non-cancerous conditions that caused bleeding, pain or discomfort. After surgery, women reported significant improvements in every aspect of sexual functioning measured by the study. Among the findings: The number of women having sexual relations at least five times a month increased by 10%. After surgery, 72% said they were experiencing orgasms, compared to 63% before the surgery. The number of women who said they had strong orgasms increased from 45% before the hysterectomy to 57% after surgery. The proportion of women experiencing pain during sex dropped dramatically, from 40% before hysterectomy to 15% two years later.

"We realize that our findings may be controversial," says Dr. Kristen Kjerulff, Ph.D., associate professor of epidemiology at the University of Maryland School of Medicine, and principal investigator for the study. "The common perception has been that hysterectomy leads to sexual problems, but our evidence shows the opposite. For most women, the surgery actually improves sexual functioning."

For example, researchers found the level of sexual desire increased significantly after hysterectomy.

Before surgery, 35 percent said they desired sex at least one day per week. That number increased to 50 percent one year after surgery and 45 percent two years later. In addition, a significant number of women who had not been sexually active in the month before surgery started having sexual relations again after their hysterectomy.

Researchers believe that relief from pain and discomfort may help restore interest in sex.

"They feel a lot better after surgery, and their desire for sex improves along with their overall health and quality of life," says Julia C. Rhodes, M.S., of the Maryland Women's Health Study in the School of Medicine. "When you look at the numbers in that context, the results are not surprising."

She says freedom from vaginal bleeding and the elimination of pregnancy concerns may also account for the improvements.

A hysterectomy is the surgical removal of the uterus, and may also be accompanied by removal of the fallopian tubes and ovaries. The leading cause of hysterectomies is uterine fibroids, benign tumors that can develop within the uterus.

The procedure may also be recommended for the treatment of cancer, menstrual disorders, or endometriosis, a condition in which the tissue that normally lines the uterus grows in other areas of the body, causing pain, bleeding or infertility.

Approximately 600,000 hysterectomies are performed in the United States every year, making it the most common major surgical procedure for women unrelated to pregnancy. "For these women, concern about sexual functioning may be the most common pre-operative anxiety," says Rhodes. "The results of our research should help reassure women that they are likely to feel better after surgery."

The majority of women who participated in the University of Maryland study were between the ages of 35 and 50. They were interviewed in their homes before their hysterectomies. After the surgery, follow-up interviews were conducted five times over a two-year period. During the interviews, the women were asked how often they had sexual relations, and how often they experienced pain during sex. They were also asked about the frequency and strength of orgasm, the frequency of sexual desire, and the frequency of vaginal dryness.

Dr. Kjerulff says a small percentage of patients did experience sexual problems following hysterectomy. "Some women were worse off and we don't want to forget those women, but for the vast majority of patients, negative symptoms were unusual."

Of the aspects of sexual functioning measured by the study, vaginal dryness showed the least improvement. Nonetheless, the number of women without vaginal dryness rose from 37 percent before the hysterectomy to 46 percent after surgery. While 35 percent of the women who had pre-hysterectomy dryness experienced no improvement, only 8 percent of the women developed vaginal dryness after surgery.

University of Maryland Medical Center

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