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Highway to Health
Women who have a hysterectomy may experience an improvement in sexual
functioning and activity, and a decrease in sexual dysfunction, according
to an article in the November 24 issue of The Journal of the American
Medical Association (JAMA).
Julia C. Rhodes, MS, from the University of Maryland School of Medicine in
Baltimore and colleagues interviewed 1132 women in the Maryland Women's
Health Study during a 2-year prospective study of sexual function
following a hysterectomy.
The authors found the percentage of sexually active women increased from
70.5% before hysterectomy to 77.6% 12 months after the procedure and 76.7%
at 24 months following hysterectomy. The rates of painful intercourse
dropped significantly from 18.6% prior to hysterectomy to 4.3% at 12
months after hysterectomy and 3.6% at 24 months.
The authors also found that orgasms increased and libido improved after
hysterectomy. Fewer women reported experiencing vaginal dryness after the
procedure. The researchers report that prehysterectomy depression was
associated with painful intercourse, vaginal dryness, low libido, and not
experiencing orgasms.
"Overall, this study found substantial improvements in sexual functioning
after hysterectomy; significantly more women were sexually active after
hysterectomy and for each sexual functioning problem the rate of relief
was higher than 60% and the rate of development was lower than 10%," the
researchers write. "Thus, the results of this study indicate that women
undergoing hysterectomy are likely to experience a good outcome in terms
of sexual functioning."
According to background information cited in the article, more than
500,000 women in the United States undergo hysterectomy yearly for
treatment of chronic benign gynecological conditions. Women often are
concerned about a hysterectomy affecting their sexual function.
"Although there are many plausible mechanisms that could account for the
observed improvements in each aspect of sexual functioning, it is also
possible that women simply feel better after hysterectomy and that sexual
functioning improves along with the overall health status and quality of
life," write the authors. "This theory is supported by the fact that the
women in this study were highly symptomatic before their hysterectomies
and reported improvements not only in sexual functioning but also in many
aspects of health and well-being. Freedom from vaginal bleeding and fear
of pregnancy may also account for some of the observed improvements."
The authors add that this study should not be misconstrued to indicate
that hysterectomy improves sexual functioning in healthy women. The
majority of patients in this study had gynecological problems; therefore,
it is likely that their problems with sexual function experienced before
hysterectomy were a result of the gynecological disorders. "It is not
surprising that removal of an unhealthy uterus would improve sexual
functioning," write the researchers. "In contrast, we can see no reason to
believe that removal of a healthy uterus would improve sexual
functioning."
JAMA. 1999;282:1934-1941 INTERACT