How would a male gynecologist begin to know anything about a woman's orgasm? Easy. In my pre-operative counseling for hysterectomy I discuss sexuality, orgasm, and hysterectomy. And I tell my patient that a year later I'm going to ask her about it. But this is not a controlled scientific study, so before telling you what I am hearing, let's look at some real data. Again, don't take my word for it. Go to the sources listed in the references. And if you like, check out their references.

First, I was amazed when I reviewed some of the early publications. Retrospective studies, with no control groups. Honestly, they proved about as much as did my "violin" example above: absolutely nothing.

Dr. Carlson also reviewed a number of studies on sexual function after hysterectomy in the above referenced article. Most interesting, perhaps, was a well done, prospective study which she co-authored: The Maine Women's Health Study (see references). In Part I a number of health related questions were evaluated before and after hysterectomy. In Part II, a comparable group of women with similar problems treated without hysterectomy were evaluated. The results are interesting. After hysterectomy 7% of woman experienced "lack of interest in sex". Of those treated without hysterectomy 6% of women had the same complaint. This is not a significant difference. "Lack of enjoyment of sex" was reported in 1% of women having hysterectomy and in no women without hysterectomy.

Another study, by L. Helstrum (see references), concluded that the most predictive factor in postoperative sexuality was preoperative sexual activity.

What women tell me after hysterectomy: The most frequent response to the question of how sex and orgasm are a year after hysterectomy is a laugh and a big smile. Most women tell me that there is no change in the way they feel orgasm, and they are able to enjoy sex more since they don't have their original problem to interfere with sex. Many others report no change. Some women tell me orgasm is better and more intense after their hysterectomy (don't ask my why). A small number of women tell me they have less interest in sex, but rarely do they consider this a problem. I have heard once that orgasm was different than before. Not "bad," just different. And some women who had sexual dysfunctions before hysterectomy had sexual dysfunctions after hysterectomy.

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