Hysterectomy and sexual function

Abstract

Hysterectomy is one of the most common major gynaecological operations performed in the UK and the USA. Its impact on sexual function is a major cause of preoperative anxiety. Unfortunately, this anxiety is seldom articulated by patients, nor recognized and discussed by clinicians. Reports about the impact of hysterectomy on sexual function have been conflicting, partly due to the use of different and often unsatisfactory parameters to assess sexual function. The aim of this review is to assess the current evidence about the effect of hysterectomy on sexual function. Female sexual function is governed by psychological, social and physiological factors. A new model of 'the sexual response cycle', comprising physical, emotional and cognitive feedback, helps explain the sexual difficulties that arise before and after hysterectomy. Evidence is lacking for sexual dysfunction caused by the disruption of local nerve and blood supply, or by changing anatomical relationships. Removal of the ovaries at hysterectomy is associated with no change or even an improvement in sexual function, particularly in women on hormone replacement therapy. Thus, overall, hysterectomy improves sexual function, regardless of surgical method or removal of the cervix. This is probably due to the amelioration of the symptoms that have previously had a negative effect on sexual function.

Sexual function after suburethral sling removal for dyspareunia

“…Reports on the impact of hysterectomy on sexual function have been conflicting, with some evidence of improvement after hysterectomy [11,12] but also of sexual impairment [13].…”

Impact of gynecological surgery on female sexual function

“…Loss of sexual function is a major cause of anxiety for women scheduled for hysterectomy. 30 Indeed, physician education is critical to mitigate this stress; a recent study showed that education about possible negative sexual outcomes predicted overall satisfaction with hysterectomy. 31 Unfortunately, despite the significance of this issue, the literature is not consistent or clear.…”

Función Sexual Tras 9 Meses De Una Histerectomía : Comparación De Los Resultados Del Cuestionario De Salud Sexual Fsm® Versus Percepción Subjetiva De La Mujer

“…Los posibles cambios en la función sexual (FS) tras la histerectomía (HT) inquieta y genera ansiedad a las mujeres que han de pasar por dicha intervención quirúrgica 1,2 . De hecho, dos estudios encontraron que el potencial deterioro de la función sexual después de esta cirugía es una de las causas de inquietud, previas a la intervención, más frecuentes 2,3 .…”

“…En un intento de resolver dichas dudas, se han realizado y publicado multitud de revisiones y estudios sin llegar a ninguna conclusión, ya que algunos de ellos deducen que la histerectomía no provoca cambios en la sexualidad de la mujer [9][10][11][12][13] , otros que la mejora 1,[14][15][16]6 mientras que otros encuentran un deterioro de la misma 3,4,12,[16][17][18][19] .…”