Hysterectomy may affect sex life

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Women who undergo radical hysterectomy to treat cervical cancer may have a lessened physical response during sexual arousal than other women, a small study suggests.

Researchers in The Netherlands found that 12 women who’d had the procedure at least one year before showed diminished blood flow to the vagina during sexual arousal—although they were as likely as healthy women to say they felt aroused.

Used to treat gynecologic cancer, radical hysterectomy involves the removal of the uterus, cervix, the upper part of the vagina and other nearby tissue. Women who have the procedure sometimes report sexual-arousal problems such as lack of lubrication, according to the authors of the new study.

Their research involved twelve women in their 30s and 40s who had undergone radical hysterectomy, and twelve who’d had a less extensive, total hysterectomy—which removes the uterus and cervix-to treat non-cancerous growths called uterine fibroids. Seventeen healthy women the same age served as a comparison group.

All of the women underwent a test that gauged their vaginal blood-flow response to an erotic film.

The researchers found that women who’d had a radical hysterectomy showed less of a blood-flow response than those in either of the other two groups, even though they felt as strongly aroused as healthy women did.

Dr. G. G. Kenter, of Leiden University Medical Center, and colleagues report the findings in the British Journal of Obstetrics and Gynecology.

The significance of the lesser blood flow seen in the radical-hysterectomy group is unclear. According to the report, the majority of women in both hysterectomy groups reported no sexual dysfunction, and only one who’d undergone the more extensive procedure said she had difficulty with sexual arousal. Four others reported having either pain during sex or problems reaching orgasm.

And, the authors point out, their study looked at one physical aspect of sexual arousal. Sexual functioning after hysterectomy, they write, is “multifactorial phenomenon” that depends on a range of physical and psychological factors.

As for the reason for the lesser blood flow seen after radical hysterectomy, Kenter’s team speculates that nerve damage during surgery may be to blame. Some research, they note, suggests that hysterectomy, especially the extensive form, may disrupt the nerves that serve the vaginal blood vessels.

However, the researchers add that recent surgical advances designed to better protect nearby nerves might help prevent this.

SOURCE: BJOG: An International Journal of Obstetrics & Gynaecology, May 2004. 

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