Hysterectomy and sexual functioning

Context Women considering hysterectomy often are concerned about its potent ial effects on their sexual functioning but the effects of hysterectomy on sexual functioning remain unclear. Objective To examine changes in sexual functioning after hysterectomy. Design and Setting A 2-year prospective study (Maryland Women's Health Stud y) of hysterectomy, which included measures of sexual functioning prior to hysterectomy and at 6, 12, 18, and 24 months after hysterectomy, performed during 1992 and 1993. Patients Of 1299 women interviewed prior to hysterectomy, 1101 (84.8%) comp leted the study and provided information about their sexual functioning Mos t were between the ages of 35 and 49 years, white, married or living with a partner, and high school graduates. Main Outcome Measures Frequency of sexual relations, dyspareunia, orgasm, v aginal dryness, and sexual desire. Results The percentage of women who engaged in sexual relations increased s ignificantly from 70.5% before hysterectomy to 77.6% and 76.7% at 12 and 24 months after hysterectomy. The rate of frequent dyspareunia dropped signif icantly from 18.6% before hysterectomy to 4.3% and 3.6% at 12 and 24 months after hysterectomy. The rates of not experiencing orgasms dropped signific antly from 7.6% before hysterectomy to 5.2% and 4.9% at 12 and 24 months af ter hysterectomy. Low libido rates also decreased significantly from 10.4% before hysterectomy to 6.3% and 6.2% at 12 and 24 months after hysterectomy . The distribution of women not reporting vaginal dryness in the past month improved significantly from 37.3% before hysterectomy to 46.8% and 46.7% a t 12 and 24 months after hysterectomy. Prehysterectomy depression was assoc iated with experiencing dyspareunia, vaginal dryness, low libido, and not e xperiencing orgasms after hysterectomy. Conclusions Sexual functioning improved overall after hysterectomy, The fre quency of sexual activity increased and problems with sexual functioning de creased.