Sexuality still intact after ovary removal

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Removing the ovaries during hysterectomy does not negatively impact sexuality or psychological well being in women taking estrogen, the results of a new study indicate.

Hysterectomy, the surgical removal of the uterus, is a common operation among middle-age women that is performed for a variety of reasons, including benign “fibroid” tumors and a painful condition called endometriosis. The issue of whether to remove the nearby ovaries during hysterectomy has been debated for more than half a century.

The main reason to remove the ovaries, an operation called oophorectomy, is to eliminate the possibility of ever getting Ovarian cancer. However, the ovaries produce key sex hormones called androgens and so removing them could, in theory, decrease sex drive and well being in women.

The post-oophorectomy state is sometimes called “female androgen deficiency syndrome,” with symptoms such as “diminished well-being and decreased libido and sexual pleasure,” study leader Dr. Adel Aziz, from Goteborg University in Sweden, told Reuters Health.

Despite a reduction in androgen levels after oophorectomy, “none of these symptoms were found one year after surgery. Thus, it is more adequate to describe post-oophorectomy as an androgen-reduced state, with no negative influence on sexuality or psychological general well-being,” Aziz said.

Aziz and colleagues based these conclusions on a study involving 362 women scheduled for elective hysterectomy. Of the 323 women who completed 12 months of follow-up, 217 had elected hysterectomy only and 106 had elected hysterectomy plus oophorectomy. The investigators evaluated hormone levels and collected data on sexuality and well being before surgery and one year later.

All women in the hysterectomy/oophorectomy group and women with menopausal symptoms in the hysterectomy group were advised to take estrogen after surgery in an attempt to make all but the androgen hormone levels equal between the groups, the authors explain in the medical journal Fertility and Sterility.

Despite the expected decrease in androgen levels in women in the hysterectomy/oophorectomy group, these women reported no changes in sexuality and an improvement in their psychological well being.

Women in the hysterectomy-only group also reported similar improvements in well being, but experienced a decrease in 3 out of 14 sexual parameters—sexual enjoyment, coital frequency, and total sexual score.

It is noteworthy, Aziz said, that there was no correlation between the changes in androgen levels and the observed changes in any aspect of sexuality or psychological well being.

This study “clearly shows that the hormonal changes after...oophorectomy in conjunction with hysterectomy during the...menopausal period do not result in significant changes in sexuality or psychosocial well being,” they conclude.

SOURCE: Fertility and Sterility, April 2005.

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