Intimacy and Sex after Hysterectomy and Cancer Treatment

How to Navigate a Healthy Post-Operative Sex Life after a Hysterectomy or Cancer Treatment

Let’s talk about sex.

If you have recently undergone a hysterectomy or cancer treatment, you are likely wondering how your sex life may be impacted. In fact, according to a study entitled “A woman’s sexual life after an operation,” up to 50 percent of women wish their doctors would discuss their postoperative sex life with them and their partner prior to their procedure.

Understanding this topic may be top-of-mind, we are explaining what sex may look like after a hysterectomy or cancer treatment. As research shows, the more knowledge you have, the more likely your intimacy is to flourish.

Read on to learn more about how these procedures can affect your sexual function and how you can work to combat potential negative effects.

How a Hysterectomy or Cancer Treatment May Affect Sexual Function

Physical Impact

According to “A woman’s sexual life after an operation,” “A recent study showed that 75% of women who had undergone radical vulvectomy or radical hysterectomy had sexual difficulties for more than six months postoperatively, and 15% never resumed sexual intercourse.” The pain and potential damage to your hormones, vascular system, and nervous system following these procedures are certainly possible causes of such sexual issues. These physical effects, however, are not the only reason you may experience sexual dysfunction after a hysterectomy or cancer treatment.

Psychological Impact

Research has found that the sociopsychological impact of such procedures may account for the biggest negative impact on postoperative intimacy and sex. This includes everything from low self-esteem due to possible disfigurement, your previous emotional state, or existing problems with intimacy in your relationship. According to  “A woman’s sexual life after an operation,” “The invasion of surgery invariably causes temporary or permanent changes, which may not be anticipated by women or may emerge only on discharge from hospital.” Another piece of research,The impact of surgical complications on health-related quality of life in women undergoing gynecologic and gynecologic oncology procedures: a prospective longitudinal cohort study,” even noted that after a thorough study of women undergoing surgery by gynecologic oncologists, “postoperative complications were associated with sustained or worsened levels of high anxiety.” This is particularly important because high anxiety has been linked to sexual dysfunction.

The most common sexual problem that seems to follow cancer treatments, including a hysterectomy, is lack of sexual arousal. That is because, according to “A woman’s sexual life after an operation,”  “Operations such as hysterectomy, bilateral oophorectomy, and radical vulvectomy can cause major genital mutilation, often producing difficult psychosexual problems.” The likelihood of a lowered sex drive after these procedures is especially high if you have a prior history of depression and you are under the age of 40. As stated in “A woman’s sexual life after an operation,” “the uterus, menstruation, and fertility are seen by many women as fundamental to their femininity. A  procedure such as a hysterectomy can truly alter our emotional state and, therefore, our arousal.

Positive Impact

Do not think all hope for your intimacy is lost after a gynecological procedure, however. In fact, a procedure such as a hysterectomy may actually improve your sex life because it can relieve everything from heavy bleeding to pain to tiredness.

How to combat negative effects to sexual function

There are a number of ways you can decrease the negative impact of a hysterectomy or other cancer treatments on your sex life. First and foremost, you should always address the issue of sexual dysfunction prior to these procedures. So congratulations, you have taken the first step by reading this article!

Prior to any such procedure, you and your partner should have a candid discussion with your physician about any current emotional or intimacy issues you are facing as well as their potential impact on your postoperative sex life. As stated in “A woman’s sexual life after an operation,” “A frank preoperative discussion is essential, and the women’s partner should be involved from the beginning. If at all possible, radiotherapy should be avoided in order to minimize the physical mutilation and to preserve the ovaries. At every follow up visit all women should be asked how their sexual life is progressing, and sexual counselling should be offered early to minimize long term damage.”

Postoperatively, focus on rehabilitation for acceptance, permission giving, and resuming sexual activity as early as possible. Counseling for both individuals and couples can be hugely beneficial when trying to navigate a healthy postoperative sex life. Research also suggests trying estrogen cream in the vagina following radiation as well as testing out different positions for intercourse.

Please note that if you are a cancer patient or have undergone a hysterectomy, you may not be able to take estrogen. Luckily, however, there are non-hormone treatments you can explore, such as ThermiVa, that produce similar results to estrogen. ThermiVa is an office-based, non-invasive procedure for labial and vaginal tightening, and this procedure could result in increased sensitivity, more coordinated and stronger muscular contractions, and the ability to achieve orgasms in a shorter period of time.[1] 

About Dr. Drake

Dr. Natalie Drake is a recognized OBGYN and leader in women’s health issues. She has not only been published in journals such as The American Journal of Obstetrics and Gynecology, Obstetrics and Gynecology, and The International Urogynecology Journal and Pelvic Floor Dysfunction, but she also works closely with physical therapists to help women with dyspareunia (painful intercourse) which can be a side effect of a hysterectomy or other cancer treatments. Dr. Drake is active in the cancer community as well and works with foundations to provide mental health support for cancer patients and their loved ones.