Endometriosis - Hysterectomy

Such complications are uncommon. In one study of 43 women, satisfaction was high, and none reported significant problems in the bladder or intestinal tract following hysterectomy.

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Treating Menopausal Symptoms and Premature Menopause after Hysterectomy

After hysterectomy, women may experience hot flashes, a symptom of menopause, even if they retain their ovaries. Surgery may have temporarily blocked blood flow to the ovaries, therefore suppressing estrogen release. If both ovaries have been removed in premenopausal women, the procedure causes premature menopause. Symptoms come on abruptly and may be more intense than those of natural menopause. Symptoms include hot flashes, vaginal dryness and irritation, and insomnia. A significant number of women gain weight.

The most important complications occur in women who have had their ovaries removed. This causes estrogen loss, which places women at risk for osteoporosis (loss of bone density) and a possible increase in risk for heart disease. Women have typically taken taking hormone replacement therapy (HRT) after surgery if their ovaries have been removed. There have been concerns however about health risks, including the risk for breast cancer and stroke, that have now limited its use. Such risks in premenopausal women have not yet been clarified. Fortunately, a number of other agents are available that can help protect both bones and heart.

In premenopausal women, such preventive measures are not needed if the ovaries are left intact. The ovaries will usually continue to function and secrete hormones even after the uterus is removed, but the life span of the ovaries is reduced by an average of three to five years. In rare cases complete ovarian failure occurs right after hysterectomy, presumably because the surgery has permanently cut off the ovaries' blood supply.

Psychologic and Sexual Concerns after Hysterectomy

Sexual intercourse may resume four to six weeks following surgery. The effect of hysterectomy on sexuality is unclear. In one major study, 70.5% of women had been sexually active before the procedure, which increased to 77.6% within the year afterward. Other studies have reported that up to 25% of women experience increased sexual drive. Nevertheless, some women report no change and other women develop problems related to sexual function. For example, around 10% of women experience vaginal dryness, about 2% of women develop pain during sex, and another 2% also appear to lose capacity for orgasm.

Two procedures associated with hysterectomy may affect sexuality directly.

Although the clitoris can trigger orgasm even if the cervix is removed, many experts believe that uterine contractions stimulated by sexual intercourse also cause a so-called ?deep orgasm.? Retaining the cervix may help to retain this sensation.
Patients who have both ovaries removed may be at higher risk for loss of sexuality. Ovaries produce small amounts of testosterone (the male hormone responsible for sexual drive) even after menopause.