Sex after Hysterectomy

  • Ask Dr G
  • Sunday, 26 Oct 2014

Oprah Winfrey once said: “It is the confidence in our bodies, mind and spirits that allows us to keep looking for new adventure, new direction to grow in, and new lessons to learn. This is what life is all about”. Indeed, life is great when our bodies and minds are in the pink of health.

In life, we occasionally are forced to make decisions that may or may not affect our long-term health. And such decisions may be a great dilemma, especially when it is clouded with uncertainties. 

When faced with medical decisions, it is crucial to seek information from as many sources as possible. In the era of Information Superhighway, it is vital to have relevant information verified by specialists or family practitioners, as the wealth of the information may occasionally be misleading. 

Reproductive health issues may be too embarrassing for open discussion. Be rest assured all doctors treats patients health issues professionally and confidentially, especially when it comes to sexual health matters.


Dear Dr. G, 

I am writing to you after building up my courage to seek opinion. 

I really hope the issues I raised will be dealt with professionally and with discretion. 

I am forty-years old, and had recently been diagnosed having fibroids in my uterus. Although my gynecologist assured me they are non-malignant, I am rather fearful the lumps had enlarged somewhat in the last two years. 

I occasionally experience some lower abdominal discomfort. However, I do not have any problem with the fibroids. 

My friends advised me to consider hysterectomy, as I have completed my family. 

My husband and I have been very active sexually, and we are worried the operation will change me and affect our relationship. 

I have read some information on the Internet about how hysterectomies can adversely affect women’s body image and mind. They also mention about how it will impair the sexual experience. 

I really do not want to ask my doctors about intimate details of my sexual feelings or enquire about how that can be affected after the operation. What would he think of me? 

I guess the easiest way to do this is ask you anonymously. 

Hope to hear from you soon 

Yours truly, 




It is not surprising many women are worried about the long-term implications after hysterectomy. In reality, hysterectomy may not have any significant impact on a women’s sexual health. In many previous studies, it has been postulated that hysterectomies may induce impairment of the nerves in the vaginal and the pelvic organs, which may affect women’s sexual wellbeing. 

Hysterectomy, or the removal of the uterus is usually carried out for cancer, fibroids, pelvic bleeding or even pelvic pain. A hysterectomy can be done either through a lower abdominal incision or through the vaginal. Both operations can also be done with the preservation of the cervix. Trans-vaginal hysterectomy may be preferred for many patients due to less hospital stay and faster recovery. However, the impact of either operation on the integrity of sexual health is less well observed. 

The surgeons tend to advice patients to resume sexual activities six to eight weeks following the operation, to avoid pain and complications. Generally, women would be fatigued during the recovery and that has a negative impact on libido. I guess the last thing anyone would have in mind after a major pelvic operation is sex. 

In a recent study conducted in the Netherlands, the effects of vaginal and abdominal hysterectomies were compared. Subgroups of patients with the preservations of cervix were also included in the studies. Six months following the operations, the participants completed questionnaires to evaluate how they perceive their sexuality, frequency of intimacy, pain, arousal and sensation. 

The study actually had unexpected findings. Many women actually had improved sexual experience following the removal of the uterus, regardless of which approach the surgery had been conducted. In fact, fifty three percent of the women became sexually active, despite remaining dormant in the bedroom beforehand. Many experts interpreted the results as sexual experience in women may enhance when they have less pelvic pain and no worries about unplanned pregnancy, following the surgery. 

Interestingly, the patients who had preserved cervix are more likely to encounter orgasm during sexual activities. This highlights the importance of cervix in female sexual experience, which may require further clinical research. 

Of course, some patients did experience a feeling of loss and depression following hysterectomy, especially women who had the removal of ovaries at the time of operations, which induced menopause. Apart from the reduced libido, the patients may also experience vaginal dryness that causes discomfort on intimacy. 

I began the column with a quote from Oprah, I will end with another one: “I finally realize that being grateful to my body was the key to giving more love to myself”. Although the recent studies may indicate less adversity of sexual health impairment, I still think it is crucial to have open discussion of your concerns with your doctors and not rely your decisions on the information over the Internet. I really hope anyone going for any operation only embarks on the surgery after the pros and cons are properly evaluated.

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