Harvard Women's Health Watch

In Brief: Hysterectomy doesn't harm - and may help - sexual function

In Brief

Hysterectomy doesn't harm — and may help — sexual function

Every year, an estimated 600,000 women in the United States have hysterectomies, mostly for noncancerous conditions such as heavy menstrual bleeding (menorrhagia), fibroids, and endometriosis. Hysterectomy removes either the entire uterus or the uterus above the cervix. The ovaries may also be removed (oophorectomy), as a hedge against ovarian cancer. Any type of hysterectomy means the end of menstrual periods and childbearing, and removal of the ovaries results in menopause and the loss of ovarian estrogens and androgens. The surgery can be performed abdominally, vaginally, or laparoscopically.

Before considering hysterectomy, women often seek alternatives, such as drug therapy. Surgical risk is always a concern — and so, too, may be the psychological and medical ramifications of losing the uterus and, possibly, the ovaries. One further worry is that hysterectomy may have a negative impact on sexual function. That idea derives, in part, from studies conducted in the 1960s by sexuality researchers William Masters and Virginia Johnson, who suggested that the uterus plays a role in orgasm. But solid evidence for a physiological relationship between hysterectomy and decreased sexual function is lacking. In 2000, a review of 18 studies of post-hysterectomy sexual function found that most women reported either no change or improved sexual functioning (Obstetrics and Gynecology, June 2000), although most of the studies were deemed poorly designed.

More recently, scientists have sought to corroborate and sharpen earlier research through the use of randomized controlled trials that take into account various psychosocial factors, including satisfaction with a partner. Finnish researchers reporting in the May 2007 issue of BJOG: An International Journal of Obstetrics and Gynaecology found that women with abnormal uterine bleeding who were randomized to receive hysterectomy reported better sexual functioning following surgery than before it.

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