your question on supracervical hysterectomy

[Guest guest]

I need to know if anyone who has had one has had any impairment in their

ability to achieve orgasm. What part does the uterus play in orgasmic

sensation? I am considering this procedure over another myomectomy.

Anne T.

Hi Anne,

Welcome to the uterinefibroids list group. As the moderator of this list

group, I received your question. I'm posting it to the entire group by

sending it to: uterinefibroidsegroups This question hasn't

specifically come up before in regard to supracervical hysterectomy, but I

know that there are women who've undergone supracervical hysterectomy on the

list group and am hoping that they will share their perspective on this

issue as well.

You ask a tricky question because the research simply hasn't been done.

Only within the last few years have sexual function researchers even

recognized and written about uterine orgasms. The 1999 edition of Our

Bodies, Ourselves was the first edition in over 20 years worth of

publication to recognize uterine orgasms. The passage on Orgasms reads as

follows:

" Masters and asserted that all orgasms are physiologically the same

(clitorally induced, with contractions occurring primarily in the outer

third of the vagina). Yet, some women describe orgasms that don't fit this

model. One such orgasm is brought on by penetration of the vagina and feels

" deep " or " uterine. "

There is no research at all that dilineates the specifics of orgasmic

location and no research that will tell you whether or not uterine orgasms

are impacted by any one procedure to the pelvic region. There IS research

that is currently underway -- but it will be years before we know the

results of that research.

Okay. That said here's what the research does say. Sexual function post

procedure is largely determined by sexual function pre-procedure. Most

women have so many horrific symptoms by the time they choose a procedure

that their sex lives are non-existent. Then, undergoing a procedure

eliminates many symptoms and they get their sex lives back. So, of course,

the pre- and post- procedure questionairres will show an " improvement " in

the women's sex lives after the procedure. That's about it. With

hysterectomy, there is about 20% chance of sexual function getting worse but

researchers consider this minor in comparison to the number of women who

register " improvement. "

As for supracervical hysterectomy -- research shows it helps and research

shows it doesn't. The studies I read each had their own biases going into

the work they were doing and the 2 major Finland studies that most doctors

refer to (depending on which side of the fence they're on) contradict each

other. Same institution. 2 different primary investigators. 2 different

answers to the question. Lots of politics. Lots of bias. Who knows which

study is really valid? Not me. I wouldn't reference either study as being

valid simply because of the way the statistics for women undergoing

supracervical hysterectomy in that country completely flip-flopped the

minute the first investigator left the institute.

There is, however, some sexual function research being done by Dr.

Berman, Dr. Berman, and Dr. Irwin Goldstein from Boston University.

They're looking at blood flow studies along with a number of other items

that might give a better indication of the role the cervix plays in sexual

function. Many (I think all but am not sure) of their patients have had a

hysterectomy and have diminished sexual function or basically an inability

to have an orgasm at all.

A couple of things to consider. If your orgasms are primarily clitoral and

you do not experience uterine contractions that you can feel or " internal "

orgasms that you can feel during sex, unless the hysterectomy is a total

muck up your clitoral orgasms should remain the same. (Actually, this is

probably true with myomectomy and uterine artery embolization and myolysis

as well.) The cervix does seem to play a role in orgasmic response,

however, and retaining it (some researchers and women believe--me included!)

increases your chances of returning to a normal sex life without additional

complications with sexual function post-procedure. Blood flow to the cervix

may play a role in sending all of those lovely orgasmic signals to your

brain.

Beyond this, the sheer surgical alteration to your vagina with the removal

of your cervix is certain to make a difference in your sexual function. To

some women, this is not a problem. To others, it is a HUGE problem. It

depends on what your own perspective about sexual function is in the first

place. Some women simply don't get a lot out of sex -- others do and enjoy

it tremendously. (You can put me in that last category and know why I was

so devastated to lose my internal orgasms with UAE.)

If you talk to gynecologists on this issue, the majority of them will tell

you it's " all in your head " and not physiological at all. Well, maybe

that's what they need to think to justify what they do to women. It's horse

pucky though. Pure and simple.

I wish there were better answers. If you only knew how much I wish there

were better answers.

That said, I want to let everyone know that on this coming Tuesday ABC's

Good Morning America is starting a Healthy Woman series of segments entitled

" What Women Don't Know About Hysterectomy. " I spoke to the producer last

week and have high hopes that she intends to give this story some true

justice. (But after the UAE and fertility fiasco I'm not exactly holding my

breath.)

Drs. and Berman will be on live on Tuesday to talk about

Female Sexual Dysfunction post hysterectomy and sharing what they have

learned to date from their research. Beth Tiner, the founder and moderator

of the Sans-Uteri list group, is being interviewed as part of this series

and will be on later in the week. If I can get transcripts from TVEYES, I

will and place them on my website. We'll see.

Carla Dionne

mailto:cdionne@...

http://www.uterinefibroids.com

member, /list/uterinefibroids