Female Ejaculation After Hysterectomy

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Female Ejaculation After Hysterectomy

SOURCES: Roovers, J. British Medical Journal , Oct. 4. 2003; vol 327: pp 774-779. Jennifer Berman, MD, co-director, Female Sexual Medicine Center, UCLA School of Medicine, Los Angeles.
Female Orgasm, Satisfaction, Improves for Most
Oct. 2, 2003 -- Sex after a hysterectomy is better, one group of researchers reports. It's been a worrisome subject for women.
And while the findings are likely true, women should still "carefully weigh the risks and the benefits of hysterectomy," says noted expert Jennifer Berman, MD, co-director of the Female Sexual Medicine Center at UCLA School of Medicine, Los Angeles. While not involved in the study, she offered her viewpoint.
For some women, sex after hysterectomy -- removal of the uterus -- can create loss of sensation -- loss of intense female orgasms, Berman explains.
"If women don't have severe pelvic pain or bleeding, or cancer , they should look at other options to hysterectomy," says Berman.
It's long been thought that, during a hysterectomy, damage to vaginal nerves and support structures may affect women's sexual well-being, writes researcher Jan-Paul W. R. Roovers, MD, an obstetrics-gynecology professor at the University Medical Center in Utrecht, the Netherlands.
A hysterectomy can be done either through an incision in the abdomen or the uterus can be removed through the vagina .
"Gynecologists generally select vaginal hysterectomy because of reduced length of hospital stay, fewer complications, and reduced costs," writes Roovers, whose study appears in this month's British Medical Journal .
However, surgeons have not known whether one technique leaves better sex after hysterectomy and better female orgasms, than the other. Does an abdominal hysterectomy leave more nerves and blood vessels undamaged? Or does a vaginal hysterectomy offer more protection to those nerves and blood vessels?
In this study, Roovers and his colleagues -- in 13 teaching hospitals throughout the Netherlands -- compared effects of vaginal hysterectomy, abdominal hysterectomy, and abdominal hysterectomy with cervix intact in 352 women.
Before hysterectomy and six months after surgery, each woman completed a questionnaire asking about their sexuality: how they perceived their sexuality, frequency of sexual activity, problems with lubrication, orgasm, pain, or sensation in the genitals, and arousal.
Sex after hysterectomy was better, regardless of the surgical procedure they had, he reports. Most of the women -- 310 in all -- were sexually active both before and after hysterectomy. But of the 32 women who were not sexually active before hysterectomy, 53% became sexually active afterwards.
However, for some women, problems persisted. Some who had abdominal hysterectomy continued to have lubrication, arousal, and sensation difficulties. Ten women who had been sexually active before hysterectomy were no longer sexually active afterwards.
In fact, there was a trend in new sexual problems in some women but no obvious increase was detected. Roovers notes that more research is needed in this area to further clarify the effect that hysterectomy can have on sex.
For some women with severe problems, hysterectomy is indeed the best option, Berman tells WebMD.
"But women who aren't suffering daily with pain -- who have a satisfactory sexual life despite whatever is going on in the uterus -- those are the women we worry about, the women who should consider other options. " Berman says.
Female orgasms involving deep pelvic contractions -- "vaginal orgasms" -- may be affected by loss of sensation after hysterectomy, she tells WebMD. "Those women will still have clitoral orgasms, albeit less intense and less satisfying, they won't lose that ability altogether."
The options to hysterectomy: "If the problem is fibroids , endometriosis, or dysfunctional uterine bleeding, there is endometrial ablation -- a minimally invasive heat balloon -- which has minimal risk," Berman explains.
"For uterine fibroids, a procedure called uterine artery embolization shrinks blood flow to the uterus, which shrinks fibroids," she says. "This procedure has been perfected so that it spares the uterine and vaginal arteries and nerves from damage."
Laser procedures are also being developed for fibroids, she explains. And for endometriosis, the new Seasonale pill can help. Seasonale is a birth control pill that delivers a continuous dose of hormones for three months, followed by one week off -- giving the woman a period every three months.
"We're getting closer and closer to organ-preserving medicine in women," she tells WebMD. "We're trying to offer women the same sorts of options we give men."
This study is the first to focus on sex after hysterectomy and female sexual well-being, notes Roovers. Trends in persistent problems warrant further study, he says.
© 2005 - 2022 WebMD LLC. All rights reserved.
WebMD does not provide medical advice, diagnosis or treatment.

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Korin Miller
Korin Miller is a freelance writer specializing in general wellness, sexual health and relationships, and lifestyle trends, with work appearing in Men’s Health, Women’s Health, Self, Glamour, and more.


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Especially for women who dealt with pain or bleeding pre-surgery.
The decision to have a hysterectomy is a big one, and it comes with a laundry list of questions. What changes will my body go through? How will it impact my life going forward? If you’re considering a hysterectomy, one of those questions will likely be: What can I expect when I have sex after a hysterectomy?
Hysterectomies are more common than most people realize. Each year in the U.S., nearly 500,000 women get hysterectomies, per data from the Centers for Disease Control and Prevention (CDC). In fact, hysterectomies are thought to be the second most common surgery for women in the U.S. behind C-sections.
In many cases, women are the ones making the choice to have the surgery under guidance from their doctor—and about 90 percent of hysterectomies are done for reasons unrelated to cancer. But there’s a fairly long list of health conditions that might cause women to consider the surgery. These are the most common, according to the U.S. Office on Women’s Health :
There are a growing number of alternative treatments for these conditions , but hysterectomies are still a fairly common choice for women who feel like they’ve exhausted their options and no longer have a need for these organs.
If you and your doctor are leaning toward a hysterectomy, doctors say it’s important to have an open and honest conversation about what this will mean for you and your life. In the meantime, here’s how a hysterectomy might impact your sex life in particular.
Not all hysterectomies are the same. During a total hysterectomy, the entire uterus—including the cervix—is removed. For a partial hysterectomy (a.k.a. supracervical hysterectomy), the upper part of the uterus is removed but the cervix is left in place. With a radical hysterectomy, the uterus and structures around it, including the ovaries, are removed. This is usually recommended if a woman has cancer or it’s suspected, according to the American College of Obstetricians and Gynecologists (ACOG).
Regardless of the type of hysterectomy, doctors generally tell women not to have penetrative sex for six weeks after surgery, says Mary Jane Minkin , MD, a clinical professor of obstetrics and gynecology and reproductive sciences at Yale Medical School. “They can fool around and have orgasms after a couple of weeks, but nothing in the vagina for six weeks,” she says.
If you want to have sex before that timeframe, it might be okay, though. “It sometimes can be sooner, depending on circumstances,” says Lauren Streicher, MD, clinical professor of obstetrics and gynecology at the Northwestern University Feinberg School of Medicine and author of The Essential Guide to Hysterectomy — like the type of surgery you had and how well you’re recovering.
Basically, listen to your body (and your doctor's guidance). If you try out some external stimulation and feel comfortable with that, you can ease into penetration with fingers or small toys and see how that feels before moving on to sex. If you feel discomfort or pain, it's best to keep waiting.
It probably won’t—or it may even feel better, Dr. Streicher notes. A majority of women said their sex life either stayed the same or got better after they had the surgery, found one meta-analysis of research on sex after a hysterectomy.
In general, you should wait to have penetrative sex until six weeks after a hysterectomy.
Dr. Streicher has also found similar results in her research. She surveyed 1,000 women who had hysterectomies for her book and found they mostly felt their hysterectomy didn’t impact their life. “For the majority of women, there was no difference,” she says. “But if a woman had painful sex or bleeding beforehand, the sex was better.”
There’s a chance that you might experience an increase in vaginal dryness , but Dr. Minkin says that’s mostly if your ovaries are removed. In that case, you will need estrogen—in the form of tablets, patches, or vaginal suppositories—to help lubricate your vagina. Using a lubricant product during sexual activity can also help alleviate dryness.
Yes, but there are some caveats. For most women, orgasms “should remain unchanged,” Dr. Minkin says. And, again, if you struggled with pain and bleeding before having a hysterectomy, sex afterward can feel even more pleasurable.
However, as Dr. Streicher points out, things will feel different in women who typically feel their uterus and/or cervix contract during orgasm. “They notice that their orgasms may not feel as satisfying or deep,” she says.
If you have your ovaries removed during a hysterectomy, Dr. Streicher says it may lower your sex drive. (Your ovaries produce hormones, including estrogen and testosterone, that fuel your sex drive.) But if your ovaries aren’t removed, this shouldn’t be an issue, she says.
A hysterectomy may also impact you mentally, and the state of your mental well-being can definitely impact whether or not you're in the mood for sexual activity. “Having a hysterectomy is a much bigger psychological deal for some women than others,” Dr. Streicher says.
It’s understandable to be nervous about having sex after a major surgery like a hysterectomy, but doctors say there are a few things you can do to make the experience easier and more pleasurable for yourself.
Overall, experts stress that sex doesn’t usually change much after a hysterectomy. “Things are usually not going to be any different,” Dr. Streicher says.
The bottom line: Doctors recommend waiting six weeks until after your surgery to have penetrative sex, but you can experiment with other sexual activities before then. In most cases, a hysterectomy won't impact your sex life much, and it may even make it better.



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