The emotional impact of hysterectomy

For the majority of women, hysterectomy is elective surgery. However, it seldom feels that way. As our post bag testifies, in many cases from the moment a woman presents at the doctors’ surgery with a gynaecological disorder, she “feels as if she’s on a conveyor belt with little information, choice or support”. Post-operatively, after a few days in hospital, she is passed medically fit and discharged to contemplate how this piece of elective surgery may affect the rest of her life and her relationships.

Removal of the uterus may be undertaken for a number of medical reasons although it is only performed to save life in relatively few cases. Whatever the primary indication, hysterectomy may be accompanied by alterations in sexuality that may occur for a variety of biological and psychological reasons. For instance, some research has shown the important role that the cervix plays in the experience of orgasm. This organ is routinely removed during total hysterectomy in the UK even when it is healthy. In other instances the symptoms necessitating hysterectomy may have disturbed the closeness of the relationship to such an extent that the couple find resumption of intimacy difficult when the physical problem has disappeared.

For some women, however, sexual problems occurring after the operation may be a continuation or further evolution of previously existing difficulties. Some women, who may have experienced years of pain or discomfort through their condition, may be so negatively conditioned towards sexual activity that they abstain or avoid sexual activity post-operatively.

However, for many women, the opposite reaction occurs. Freed of the symptoms as a result of surgery, a woman may find her sexual responsiveness reawakened. With myriad different reactions possible, it is perhaps not surprising that post-operatively there is an increased incidence of depression when compared with the after effects of other major surgery.

The success of the operation then depends upon two things, each as important as the surgeon’s skill; the woman’s self esteem and the partners reaction.

Research has shown a crucial link between information giving and the perception of being cared for by health professionals. Women who present their bodies to medics without knowledge or understanding of the what, why and after effects, suffer considerably more post-operative complications than the woman who insists on knowing as much as possible and feels in control at all times [except whilst under the anaesthetic of course!] After all, a woman is the greatest expert in the world on herself.

The woman’s husband or sexual partner is the second most important factor in determining the success of surgery. Most men (and quite a few women) don’t understand the nature of the female anatomy or the functional results of hysterectomy, and may harbour many misconceptions regarding sexuality after the operation. If the man equates removal of the uterus with loss of libido or diminished femininity, he may inadvertently avoid sexual interaction with her. Men who appear indifferent to uterine removal, may actually feel anxious or guilty about subsequent sexual activity with their partner.

A hysterectomy can be seen as a unifying experience, one that the couple face together, talking and listening to each others needs, communicating their feelings as they change day by day.

With the right support network in place, which should include her partner as well as medical staff, there is no reason why a woman’s sexual function cannot improve following recuperation from the operation. If health-care professionals take the time that is necessary to assuage fears and doubts regarding such operations and provide a reasonable amount of factual information to both the woman and her sexual partner, few sexual difficulties will ensue postoperatively. However, whilst counselling is routine prior to sterilisation or vasectomy, no such norm exists for hysterectomies. As with all types of surgery that may have an impact on sexuality, such counselling ought to be a routine part of the care for a hysterectomy patient.

Recommended Reading:

star buy Losing the Woman Within – £5.50. is essential reading for everyone who feels they are alone and emotional following a hysterectomy.

Recommended Resources:

14 thoughts on “The emotional impact of hysterectomy

  1. Betty

    I was informed yesterday during a routine annual exam, that ended up lasting 4 hours and a uterine biopsy later. That I would need to have a hysterectomy done. They did the biopsy because he said there were polyps. No medication at all for this procedure, I really didn’t think that it would be too painful but sure enough I was surprised by the pain all evening. That was the least of my worries, sitting there alone is when the doctor said That I needed a hysterectomy. I am 34 with 2 children, I really did not plan on having more children, never did I think that I would have to have a hysterectomy. My uterus is tilted and because of the difficult childbirth I had it is prolapsed also. I feel so lost and I cant stop crying. I feel like I am loosing part of my womanhood. My boyfriend is treating me as if I have the plague, which is just making things worse emotionally for me. He is 50 and had a vasectomy many years ago so I ruled out him being upset about no more children. I feel so alone.

    1. Linda Parkinson-Hardman Post author

      Your reaction is all too common and it’s OK to feel as you do Betty. It’s a big shock and you will naturally feel that a part of life has ended. However, it might be worth talking with the boyfriend in more detail because it may be that he’s just worried or frightened himself.

    2. Latrice

      I’m 10 days post surgery my cervix and uterus was removed, I’m 36 yrs old. and like yourself it was a total shock for me when I was told I felt the same feelings you are feeling and it’s perfectly understandable. Maybe your boyfriend is afraid and don’t understand enough about the surgery, maybe going to the doctors with you and have the doctor explain to him about the procedure and even try therapy. I hope all goes well with you and your family. On a brighter note I feel much better now that it’s over there’s always a light at the end of the tunnel.

  2. Tesse

    I had a hysterectomy 4 weeks ago and still have waves of nausea and have had similar emotion responses. I don’t think I understood how hard this would be emotionally.

    1. teen

      i am the same will be 5 weeks today for mine,i have good days and bad days ,where i think am just about to start to feel ok then the next day will be pain again nausea and just feeling exhausted xx

  3. Renée

    Hi, I am 37, two weeks ago today, I just had an abdominal hysterectomy, both ovaries and tubes were removed-I had large cysts on both ovaries and suffered from terrible periods. I am moving around pretty good. One of my main problems is that I feel sick a lot of the time-does anyone else feel sick after having this surgery? My other problem is that my emotions are all over the place. I am single, my Mom has been a God send during this ordeal but I feel so very alone. I have concerns/fears about having sex with someone new after having this surgery. I’m not dating or have anyone in mind so it might be silly to worry about this now but I worry none the less….will I work “down there”,’will I need lubricant? Who will want to be with me? So forth…
    I had my tubes tied after my second son was born 11years ago-BIGGEST MISTAKE OF MY LIFE, I had always hoped to have the reversal done…but now…I know that I will never have more children. No one seems to understand how badly this is affecting me. I see a newborn at the store and all I want to do is blaw my eyes out. I am so tired all the time, I feel alone and empty. Is this normal? And sick, I feel sick. I don’t get sick very often and brush it off when I do, so why do I feel sick now?

    1. Linda Parkinson-Hardman Post author

      It’s perfectly normal to have an emotional reaction to the surgery – it may be driven by how you feel or by things like the anaesthetic, but it is common. If it is purely about your emotions and coping with the sense of loss then it may be worth talking with a counsellor who could help you deal with that.

  4. Del

    I’m in my early 40s and had premature ovarian failure (early menopause) when i was in my late 20s after a myomectomy my periods stopped. However, i had an abdominal hysterectomy 7 weeks ago but the cervics was left intact due to adhesions it was decided during surgery, that was the best option othetwise it may have left me incontinent had they removed it. My surgeon said i had gross adhesions my organs were stuck together ie bowels, bladder, womb, cervics etc so they had to divide everything to remove the womb, tubes and ovaries. I’ve had the best care from my consultant and the hrt team who’ve looked after me two years after my premature menopause. But before that i had to deal with everything myself never had conselling and it’s been tough for me. Sometimes i felt like giving up. Now after the hysterectomy 7 weeks ago i am feeling so low, teary all the time i just keep thinking of what happened during the myomectomy years ago, am having flash backs and feel sad about the whole thing. I feel emotionally drained. I accepted years ago that i would never have children the day they told me that my ovaries had ceased. Because they say when you’ve gone through menopause before having hystetectomy you do not feel anything so why am i feeling like this? I’ve also got joint pains and i feel tired with no energy all the time. Thank you!

    1. Linda Parkinson-Hardman Post author

      HI Del, firstly it’s perfectly normal to feel the way you do so don’t be hard on yourself. Firstly you’ll be having a reaction to the surgery itself this, then the fact that your ovaries and womb have removed will have an impact on your hormone levels – which will be all out of kilter too. Finally, you’ve just had major surgery. Give yourself some time and things will improve.

  5. joy

    so relieved my syptoms are normal, why is there not councelling post op as standard. I spoke to my doctor, my husband and i have relationship problems so part of me has been putting the lack of self-esteem and mood swings to the fact that we are still not getting along.

    So i made a appointment with my doctor who put me in touch with steps to wellbeing dorset. I had appointment today as a refferal . It is not a councelling referal for post -op, i am dissappointed. The lady was very nice and has made an appoint.ment for me to group discussion. But it isnt , i feel the way forward.

    Will i have to pay privatley to get the councelling i need post-op/?Ive been feeling really low in myself for 3 months, i hate my body because of the scarring, i dont want my husband to touch me without my clothes on.

    My thoughts are about leaving him because he would be better off without me.

    1. Linda Parkinson-Hardman Post author

      Hi Joy, you may be able to access counselling for yourself through your GP free of charge. There are often NHS counsellors attached to surgeries. However, if it’s relationship counselling you are after you will need to contact Relate. They have an offices in Dorchester, Bridport, Shaftesbury, Yeovil and Blandford.

  6. Hayley Martin

    i had a abdominal hysterectomy and bso nearly 3 weeks ago.I was so focused on relieving the chronic pain of adenomyosis that i never realised the emotional havoc it causes. I have been so terarful snd thinking so illogically that i am slipping down a slope into depression. I commenced HRT pre op but consultant is going to change it at 8 weeks post op,are my feelings normal?

    with Thanks
    Hayley

Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>