During my 20s, a doctor suggested I consider getting a hysterectomy to relieve the chronic aching in my pelvis caused by my recurrent endometriosis. While I didn’t get my uterus removed, I know women who have. And when actress Lena Dunham got a hysterectomy at 31 to treat her pelvic pain — followed a year later by the removal of her left ovary — it pushed the procedure among young women into the mainstream. After many conversations about this procedure, I was left wondering: does a hysterectomy affect how sex feels? Studies show that most women report the same or better sexual function after a hysterectomy. Since the uterus can be a source of pain, it can contribute to sexual suffering in those who have heavy and irregular bleeding due to cysts, polyps, or fibroids, or those with conditions like endometriosis or adenomyosis — when endometrial tissue grows in the muscular walls of the uterus. If removing the uterus relieves these issues, sex is often better because it hurts less post procedure. “By taking out the offending organ, you’re fixing the problem that is a primary source of sexual dysfunction,” says Dr. Christina Lewicky Gaupp, a urogynecology and pelvic reconstructive surgeon at Northwestern Memorial Hospital in Chicago. “Women feel much better afterwards.” The role of the cervix For those who climax through clitoral stimulation, removing the uterus shouldn’t have a negative effect on reaching orgasm. However, some females like vaginal or cervical stimulation, and there is an ongoing debate about whether removing the cervix might decrease sexual pleasure in these women. “When the cervix is removed, that may alter some women’s feelings during intercourse,” says Dr. Alyssa Dweck, a gynecologist in Westchester County, New York. “So that has to be taken into account.” If you aren’t at risk for developing cervical cancer, a partial hysterectomy — which leaves the cervix intact — is an option. But if your cervix remains, you have to keep up with your Pap smears for as long as you would if your uterus was intact. If you have a hysterectomy because of cancer or precancerous reasons, the cervix is taken out along with the uterus to remove or prevent cancer cells from spreading. Why the ovaries matter If a hysterectomy also includes an oophorectomy — removal of one or both ovaries, this won’t make much of a difference in the hormone levels of those who are postmenopausal. But it leads to surgically-induced menopause in those who haven’t stopped having their periods. This can affect sexual function not because the uterus is gone, but because the ovaries are no longer there to produce estrogen. This can change the way sex feels because of increased vaginal dryness, painful penetration, or a decreased libido. If you’re worried, talk to your doctor The type of hysterectomy someone has depends on what issue needs resolving. But whether you’re having the procedure to relieve pelvic pain or treat cancer, you’ll most likely feel relief after. And if you’ve already had kids, or you want to remain child-free, a hysterectomy removes the need for birth control. One woman I know — who already had children — got the procedure because of a cervical cancer risk, before natural menopause set in. She said her sex life and orgasms weren’t affected by the procedure. If anything, she said the relief of avoiding cancer coupled with knowing she couldn’t get pregnant made sex more satisfying. If you’re anxious about what might happen to your sex life, you should discuss your concerns with your doctor. You can often leave the cervix and hormone replacement therapy can lessen menopause symptoms if you have to get your ovaries removed. The bottom line is that hysterectomies are performed because of a gynecological problem, often one that makes sex painful. Resolving that complication can often improve sex. So if you have to have the procedure, don’t worry that your sex life will be ruined. In fact, it might even be better.

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