Sex After Surgery

So your doctor has recommended that you undergo gynecologic surgery: maybe a hysterectomy to get rid of fibroids; maybe surgery to lessen incontinence by "tightening up" prolapsed, or fallen, organs resulting from pregnancy and childbirth. The doctor answered all your questions about the surgery itself. But, what you want to know now is how it will affect your sex life.

Let's take a look.

Hysterectomy. How a hysterectomy affects your sex life depends, in part, on the type of hysterectomy you have. On the other hand, a hysterectomy may relieve symptoms that were affecting your sex life prior to surgery, such as fibroids. In one survey of 678 women, 24 percent of women whose ovaries were removed as part of the hysterectomy said their sex lives were worse after the surgery, compared to just 11 percent of those whose ovaries were preserved. Plus, 74 percent of women who kept their ovaries said their post-surgical sex lives were better compared to 55 percent of women whose ovaries were removed (the remainder of the women said their sex lives hadn't changed).

The difference may be due to the loss of androgens, which are produced in the ovaries and play a role in sexual desire.

Overall, however, reviews of studies on sexual function following hysterectomy generally find that women say their sex lives are either better or the same after surgery, but it's important to note that a hysterectomy will not cure sexual dysfunction. In addition, women who have healthy sex lives before surgery will likely continue to have healthy sex lives post-surgery. As you might expect, a major component in terms of how well their post-surgical sex lives went depended on their relationship with their partner. Another determining component? The worse their pre-surgical menstrual pain, the better the women rated their post-surgical sex lives. This is also true for women suffering from pain with sex, a condition known as dyspareunia.

Surgery for pelvic organ prolapse and urinary incontinence. These conditions often lead women to stop having sex altogether because of incontinence during sex.

Surgery to correct incontinence related to organ prolapse includes the use of synthetic slings or tape to hold organs in place. One of the few studies on sex after such surgery showed mixed results. Some women demonstrated significant improvement on tests designed to measure sexual function-including how often they have sex-while others reported that they were less able to achieve orgasm and that they and their partners were less satisfied with their sex life after the surgery.

In this study, however, the women were only followed for six months after surgery; their sex lives may have improved had more time been allowed for healing during the assessment. The researchers also didn't know why these women's sexual satisfaction declined, but suggested it could be due to worry that sexual intercourse might damage the surgical repair.

No matter what type of gynecologic surgery you're having, talk with your health care provider about your concerns regarding sex following surgery. Ask your doctor to carefully go through all the potential complications and what he or she will do to avoid them; what you should do post-surgically to ensure healing; and how long it will be before you can resume intercourse.

Also, talk with your partner about any upcoming surgery and the effects it might have on your physical health, as well as your sex life. If you're likely to be out of commission for a bit after surgery, consider asking other family members for help during the healing process (e.g., cooking meals, doing laundry), so you can get back on your feet and back to your sex life when you're healed.