| Dear Carol, I had a complete hysterectomy on December 3rd. While my recovery has not been without complications (i.e., a bleed out, delayed healing in the vagina due to granulation tissue), my sexual encounters with my life partner since then have been rather disappointing. More specifically, it is difficult for me to obtain orgasm and, when I do, it is considerably less intense and very brief. Do I need to be more patient and allow more time for a "full recovery"; or, is this the type of orgasm I can expect now that I've had a hysterectomy? (I certainly hope not!) Thank you
for your guidance and sharing your expertise! Dear Post Op, Best wishes for your continuing recovery! In fact, especially given that you've had complications, I would not say that you're fully recovered just yet, and it's possible that your ongoing healing process will have a positive effect on your orgasms. However, I wouldn't just wait for that to happen if I were you. Even skillfully done surgery with no post-surgical problems can affect the nerves in the area, and orgasm, of course, is linked to the well-being of the nerves. Many authorities have given short shrift to the sexual effects of hysterectomy, and even very contemporary discussions of it can have this failing. Doctors may claim never to have heard that women's sexual response might change after hysterectomy, or they'll write off real changes as psychological: "She feels like less of a woman now." For some women this is a true issue. Still, you might feel like as much a woman as you ever did, but if you have one of the handful of fairly common responses to hysterectomy outlined by "Our Bodies, Ourselves" that make sexual response problematic, there are very physical reasons why. That so many medical doctors do not understand this even today is a scandal. Ironically, a heightened focus on understanding women's sexuality might be partly to blame, because since at least the days of Masters and Johnson in the 1960s the medical profession has accepted pretty uncritically the idea that female orgasm is centered in the clitoris. And that's not very nigh to the uterus; how can uterine removal cause sexual dysfunction? It can do so in three main orgasm-affecting ways (and a couple more mechanical ways). First, some women's orgasm-triggering responsiveness is really more vaginal, whether via G-spot stimulation or through cervical touch. And there is now some acknowledgement that perhaps there are two separate genital nerve pathways leading to the spinal cord and hence to the brain: one from the clitoris (or penis or phallus, if we're talking a male or female-to-male transgendered person), and one that is more uterine or G-spot- (or prostate-) centered. This latter one is the nerve path that hysterectomy might affect. Furthermore, many women (including you, I bet) experience uterine sensation, even contractions, upon orgasm. If your uterus is gone, so are those contractions. Finally, you don't say whether you had a total or a radical hysterectomy, but if it was the latter, your ovaries are also gone, which means you're dealing with substantial hormonal changes. Included in these is a loss of androgens -- testosterone, in fact -- which can be as crucial for a woman's sense of arousal and sexual response as it is for men. Let me address these things one at a time. If you are dealing with damage to the nerve pathways, it's very important that you continue sexual stimulation, maybe even add extra masturbation to your routine for a while. If you are to regain any neural function, you won't do it by giving up the kinds of stimulation that mattered to you before. This might be frustrating, if it evokes your sense of having been altered sexually, but try to focus on what *does* feel good about it, and persevere. It might even be a good time to add other erotic elements to your sexual experiences, more and different sorts of sensual stimulation. Orgasm is truly in your head, so if you can add as much pleasurable, erotic experience as possible to your repertoire, it will only help as you re-learn your responses. If you were a uterine-contraction type of orgasmic woman, work on your Kegel (a.k.a. pubococcygeal) muscles. (Betty Dodson's book Sex for One and her videos, as well as her toy Betty's Barbell, are all good Kegel exercise resources.) Strong vaginal muscle contractions might help make up for your changes in uterine response. And if yours
was a radical hysterectomy, ask about testosterone creams or tiny under-the-skin
implants (Our Bodies, Ourselves warns you might have to look around to
find a doctor that knows about these, but their use is, I believe, getting
more common). And whether or not you choose hormone replacement therapy,
check with your physician to see how much you can exercise. Regular exercise
helps boost the body's production of testosterone, and I'd recommend as
much exercise as your healing process will allow. Not all our hormones
are made by the ovaries, so even if yours are gone, the rest of your endocrine
system will pick up some of the slack Finally,
here's a brief list of web sites on which information and in many cases
chat opportunities can be found for women who've had (or who have been
recommended to have) hysterectomy. I'm sure these will link to others.
You might find it a help to communicate with other women in your boat.
Good luck! |
