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Sexual Desire Disorder.

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Based on my latest consultation with Dr Aarti Vazarini, I 'm reluctant to have a hysterectomy because of what I been reading. Hysterectomy accelerates aging, lost of sexual desire, osteoporosis, cardiovascular problems etc.... Based on what I've research most of these effects have been discovered lately. . So when you have all this information I keep asking to myself, is this the way to go, if they're alternatives that 10 years ago were not available? Please let me know your thoughts about this?


Category: Family Physician-GP

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Category: Sexually Transmitted Diseases(STD)Specialist
Dr. Deepu Sebin Sebastian is online now

Expert:  Dr. Deepu Sebin Sebastian replied 4 Days.

Hello,

Thank you for choosing DoctorSpring.

I have reviewed your previous consult with Dr. Aarthy. I understand this is a difficult decision for you, but my opinion would be that you should go for the surgery. Of Course this is not a perfect solution, but a trade off when you have to choose between risk of Cancer and Hysterectomy.

Regarding the side effects I think you are ill informed. There are side effects, but most outcomes are positive. Please alllow me to quote few major studies (With reference)

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1. "Many prospective studies have found therapeutic effects of hysterectomy, including improvement of mood and quality of life. Multiple studies have shown that hysterectomy, with or without oophorectomy, appears to have few, if any, effects on sexual functioning [ 66,71-74 ].

2. The Maine Women's Health Study of 418 women showed hysterectomy led to marked relief of pelvic pain and vaginal bleeding. There were also modest improvements in self-reported feelings of depression, fatigue, sexual dysfunction, and other symptoms associated with nonmalignant conditions of the uterus [ 75 ]. A limited number of women reported new problems such as hot flashes (13 percent), weight gain (12 percent), depression (8 percent), anxiety (6 percent), and lack of interest in sex (7 percent).

3. The Maryland study (discussed above) also noted improvement in the proportion of patients reporting depression or anxiety before and after surgery (depression 28 versus 12 percent, anxiety 65 versus 25 percent, before and after hysterectomy respectively) [ 68 ]. In addition, 48 percent of patients described limited physical function and 23 percent described limited social function before surgery compared to 23 and 5 percent, respectively, 24 months after surgery.

This study also assessed measures of sexual functioning prior to hysterectomy and at 6, 12, 18, and 24 months after the procedure [ 71 ]. The percentage of women who engaged in sexual relations increased from approximately 71 percent before hysterectomy to 77 percent at 12 and 24 months after hysterectomy; the rate of frequent dyspareunia dropped from 19 to 4 percent; the rate of experiencing orgasms increased from 92 to 95 percent; and libido increased. Overall, the frequency of sexual activity increased and problems with sexual functioning decreased postoperatively.

4. A multicenter study from the Netherlands noted no difference in sexual function by hysterectomy procedure (abdominal, vaginal, or subtotal) [ 66 ]. There was a significant increase in sexual pleasure after each of the three procedures.
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Many of the symptoms you have mentioned occurs when the ovary is removed. In the postmenopausal period invariable all women will have risk of osteoporosis, decreased sex drive, increase heart disease risk etc. I am not promoting hysterectomy or anything here. Just make sure you getting your information from correct sources and be open about the options.

If there was any possibility I would go with preserving the uterus. But since the modern surgical procedures are safe may be it is better to offload the cancer risk. Even 10 year before the option would have been hysterectomy.

Hope this helps
Feel free to ask follow ups
Thank you


Dr. Deepu Sebin Sebastian
Category: Sexually Transmitted Diseases(STD)Specialist
Experience: 
MD, Internal Medicine - Stanley Medical School
Medical School - MBBS - Govt. Medical College, Kottyaam

Diagnostic Prediction - Stanford School of Medicine
Received Specialty training in Critical Care, Cardiology, Neurology, Gastroenterology, Nephrology from Stanley Medical College and in Endocrinology, Rheumatology.

Hematology and Geriatrics from Madras Medical College.
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