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Elizabeth Rattray had only been married a few years when she found out she needed a hysterectomy (surgery to remove the uterus) to relieve the intense pain caused by uterine fibroids. “I was really devastated because I kept thinking, ‘This is going to be a nightmare,'” says Rattray, a Cleveland-based Medicare licensed insurance broker.

The fibroids had enlarged her uterus to “the size of 5 months of pregnancy,” Rattray recalls. She began to worry about the health implications of losing her uterus, being unable to bear children and how the surgery might affect sex with her new husband. The couple were in their early 30s.

Rattray researched and obtained several medical opinions. She says a doctor suggested surgery to remove her ovaries along with her uterus. Rattray recalls that nothing happened that required her ovaries to come out.

Rattray and her husband eventually traveled from Cleveland to Atlanta for a laparoscopic hysterectomy at the recommendation of a trusted friend. The surgeon she chose agreed that she could keep her ovaries, so she did. The surgery and recovery went well. Rattray says her sex life is better than ever. Everything works and everything is fine,” she says.

How long to wait

Sex after a hysterectomy is a major concern for many women considering the surgery, but it doesn’t have to be, says Maureen Whelihan, MD, an OB/GYN in Palm Beach County, FL.

“You can have sex anytime after the hysterectomy — sexual stimulation, orgasm, manual stimulation,” Whelihan says. You have to give him time before having vaginal penetration sex. “You may want to wait about 4 weeks to allow the top of the vagina to heal,” says Whelihan. “If it’s a really complicated operation, the doctor might ask you to wait 6 weeks.”

“Just as a reminder,” she adds, “there are many other avenues for sexual fulfillment and liberation that don’t require penetration.”

After the healing period, women shouldn’t feel pain during sex after a hysterectomy, Whelihan says, unless it’s in the area that underwent surgery or possibly when there’s pressure during a sexual position near a surgical incision across the abdomen exercise partner is up.

Get answers to your questions

As with anything else in your medical care, it’s best to know your options, the pros and cons, and your preferences.

Get second and third opinions when needed, says Dr. Francesca M. Rogers, obstetrician-gynecologist at Woman’s Care at the Pavilion in Burbank, CA.

That means asking important questions, like whether your ovaries really need to be removed. That was common practice in the past, Whelihan notes. But it is not always necessary. So if it’s recommended, make sure you know why.

libido

Removing your uterus will not affect your desire. But that could happen if you have your ovaries removed, as well as your uterus.

“Sexual dysfunction is caused by the loss of the ovaries,” says Whelihan. The problem is really the loss of the hormones that the ovaries produce. “The problem wasn’t the hysterectomy,” says Whelihan.

If your ovaries need to be removed along with your uterus, hormone replacement therapy safely replaces some of the lost hormones, Whelihan says, and may also help lower the risk of cardiovascular problems related to estrogen loss. Most premenopausal women have no change in libido if they start HRT at the time of surgery.

Many things affect a woman’s sex drive, including stress, relationship problems, and other health issues.

Remember that if the sex still doesn’t meet your expectations, it may not be a physical problem. Whelihan examines her patients to check their mood. She estimates that about a third of her patients with low libido “have underlying anxiety or depression that isn’t properly managed.” Treating these other conditions can help your libido.



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