Hysterectomy, instant menopause, and sex life?

[Tybee Swing]

I've been going through some "stuff" for several weeks now. It started with a distended, hard belly and lots of discomfort. After visiting my GP, getting bloodwork and an x-ray, then being sent out for ultrasound and CT scan, it was discovered that I have a huge ovarian cyst. The thing is literally the size and shape of a rugby ball. I feel like I have a rugby ball in me. There's more, but I'll spare all the details.

The verdict: The cyst must come out. My gyn/surgeon feels that "everything else" must come out, too. I agree with her on the ovaries - both of them (long story, too many details). This will mean "instant menopause" when I get them out! She also wants to take out the fallopian tubes, uterus and cervix. I'm opposed to having the uterus and cervix taken out just to prevent the possibility of future cancer. The cyst is almost assuredly benign (preliminary tests show this). There is no history of cancer with me or my family. My 98-year-old granny still lives in her own home and is going strong, for pete's sake. I'm fighting the uterus/cervix removal idea. I have many reasons for this, including sexual function and the ability to have the "deep" vaginal orgasms I have. These actually involve the contraction of the uterus and stimulation of the cervix...without those organs, no more (or very diminished) "deep" orgasms. Yeah, there are still clitoral orgasms (inferior to the deep ones I have), but even those may be diminished, especially due to the loss of hormones. Even my sex drive itself is at risk. I fear above all that I'll lose interest!!!!! The loss of my libido would be devastating to me, not to mention my husband.

Surgery is this Thursday. I'm studying everything I can get my hands on, frantically absorbing it all. I have to make decisions about things like HRT. I'm faced with many articles and tons of information. It's overwhelming. Then, there is the long recovery and who-knows-what with emotions, mood swings out of the blue, all sorts of physiological changes, and so much more.

Meanwhile, our swing profiles are on "invisible" now. There is no way to know how long I'll be out of commission. No way to know when we two will have our sex life back on track (hoping we'll get it back like it is now). Apparently the surgical recovery before any sort of penetration can be attempted (and then only carefully) is 6 weeks. Many articles I've been reading indicate that it can be months or even a year to get back on track sexually. I really hate that for both myself and my husband!!

I've read everything here in the archives that I could find. Most of the best threads on menopause and hysterectomy are much older threads. I read many valuable tips and facts (some quite sad - some more optimistic). The most helpful of all to me were written by ElusiveBiFem. However, they were all pretty old. I don't think this subject has been here much in quite awhile.

Are there any women here who've been through menopause, whether natural (gradual) or surgically-induced? Anybody had their ovaries surgically removed? How has it affected your sex life? Your life in general? Any tips to share? Any thoughts for me?

Anybody still swinging who's been through this? How long did it take you to get back in the saddle with swinging? In what ways has it affected your swinging life?

Thanks for anything you all can offer.

[sexyshelby]

Unfortunately, I can't offer any tips or advice, but I just wanted to say that we'll be thinking of you. Good luck and hang in there.

~SS

[DGrey]

I just want to give you a hug because I have no advice to offer up to you. I will tell you though to make sure you and your husband speak up and make sure that when you sign all those endless consent forms, you write on it somewhere that the uterus and cervix are not to be removed.

Have you discussed the possibility of having an epidural so that if anything should arise, you can discuss it with the surgeon right then and there?

I'll be thinking of you.

E

[BnSinbville]

Bless your heart sweetie. I'll be thinking of you. I can't answer all of your questions, but I had a hysto 3 years ago. They left my cervix, I had the last bits of both overies removed and my uterus. I had fibroids. All I can tell you is SEX IS GREAT FOR ME. You didn't say how old you are, mine was 3 weeks after I turned 50, I need no hormones or anything. My Doctor thinks its because I was just ready to start menopause??? who knows...I do think tho that a postitive attitude is a plus, our minds can do wonderous things against all odds.
I had lost my husband 4 weeks before surgery and had not had sex with him for years due to illness, so I didn't have sex until a year later when I was ready to start dating. All I can tell you is my experience to hopefully reassure you some.
I'm hornier than ever, have no problems with dryness or anything. The only problem I really experienced is that I lost skin tone..I now have the (I call) little old lady wrinkles in the skin on my arms. If I can tell you more please let me know, I will share whatever info I know. Also is your doctor a woman? Good luck with your decision and your surgery. Oh one last thing besure that you get out of the bed asap and walk...even if only baby steps..it will help you recover faster. S

[NJCouple]

I had a partial hysterectomy years ago due to severe bleeding fibroids. They left my ovaries and cervix and just removed the uterous. I had to decide on the cervix. It was recommended that it be removed. The cervix, however, plays a role in holding the bladder in place. Many woman suffer from a dropped bladder which must be attached to the abdominal wall etc and can cause other problems. I felt it would be better to continue my pap test regimin for the rest of my life rather than risk incontinance problems etc. I would definately research this and discuss it with the doctor more. If you are at a higher risk for cervical cancer, your decision may be different than mine.
Good luck, Sharon

[Tybee Swing]

Shelby and Erika, thank you.

Originally Posted by BnSinbville

Bless your heart sweetie. I'll be thinking of you. I can't answer all of your questions, but I had a hysto 3 years ago. They left my cervix, I had the last bits of both overies removed and my uterus. I had fibroids.

S, thanks for writing me! You say the last "bits" of your ovaries were removed. They were partially removed before this??

Originally Posted by BnSinbville

All I can tell you is SEX IS GREAT FOR ME. ..I need no hormones or anything. My Doctor thinks its because I was just ready to start menopause??? who knows...I do think tho that a postitive attitude is a plus, our minds can do wonderous things against all odds.
..I'm hornier than ever, have no problems with dryness or anything.

Wow, it's great to hear all of this! Did you not have mood swings, no hot flashes, none of that?

Originally Posted by BnSinbville

I had lost my husband 4 weeks before surgery and had not had sex with him for years due to illness, so I didn't have sex until a year later when I was ready to start dating.

I'm so sorry for your loss, and what timing. It must have been awful for you.

Originally Posted by BnSinbville

The only problem I really experienced is that I lost skin tone..I now have the (I call) little old lady wrinkles in the skin on my arms.

From what I've read, this is due to the slowing down of the production of collagen in the skin, related to the decrease in estrogen. An estrogen cream helps (even low dose). Collagen keeps our skin and muscles young and supple. I'm all for that!

Originally Posted by BnSinbville

Also is your doctor a woman?

Yes, she is. I've been seeing this doctor for ob/gyn for a few years now. She seems compassionate and very knowledgeable.

I know that your physical recovery was happening during the time of your widowhood, and it was quite awhile before you were having sex again. But I wonder, do you know how long your recovery took, sexually speaking? After you did start having sex again, was anything different? Were your orgasms "different" or diminished at all? Was it harder to self-lubricate (took longer)?

How long did your recovery in general take....until you were up and around, doing normal things (like, able to do a desk job)?

I'm so glad to hear that your libido stayed strong. Thanks for all your help, and if you think of anything else, just let me know! I'm all ears.

Hugs, TS

[Tybee Swing]

Originally Posted by NJCouple

I had a partial hysterectomy years ago due to severe bleeding fibroids. They left my ovaries and cervix and just removed the uterous. I had to decide on the cervix. It was recommended that it be removed. The cervix, however, plays a role in holding the bladder in place. Many woman suffer from a dropped bladder which must be attached to the abdominal wall etc and can cause other problems. I felt it would be better to continue my pap test regimin for the rest of my life rather than risk incontinance problems etc. I would definately research this and discuss it with the doctor more. If you are at a higher risk for cervical cancer, your decision may be different than mine.
Good luck, Sharon

Sharon, thanks! No, I'm not at higher risk for cancer; if anything, lower risk. There's no family history here. My granny is 98 and lives on her own! We're a healthy bunch. I don't smoke, I eat extremely healthy, exercise, a very clean-living type.

I know what you mean about the bladder. I have a friend whose bladder was actually falling out through her vagina! Due to total hysterectomy. Poor thing!!! She had to have it surgically "tacked up". She is one of the women I know whose libido is completely dead now, too.

Originally Posted by NJCouple

They left my ovaries and cervix and just removed the uterous.

In some women, the ovaries keep on working just fine, producing hormones. In others, the ovaries soon fail after the hysterectomy, anyway. Are yours still working? No menopause yet? That would be great, but my ovaries really do have to go.

How long was your recovery time before you could comfortably have sex? How long until you were feeling normal and able to do typical things, and have a normal amount of stamina?

And may I ask....how is your libido?

Thanks.

[NJCouple]

I've always had a high sex drive and was not about to let surgery slow me much. LOL. Hubby and I had sex without penetration within a week of surgery. I waited several weeks for more. My ovaries worked fine for years after. Its been 14 years now and only within the past 2 years have I started taking hormones. I did not do this because of libido, but because of mood swings. I did not reallly want to murder my husband. LOL. I am currently on activella, a very low level hormone replacement. My ovaries still kick in every few months, but this helps to regulate things for me. I have had no problems with lubrication, desire, feeling etc. If anything our sex life is so much better. There is no concern about pregnancy and not getting my period is wonderful! I actually feel kind of smug when other couples' play time is cramped by "that time of month." It makes me feel more of a woman as I can please my husband without having these concerns. I think a lot of the lack of desire is in the mental attitude and so I chose my unusual outlook to compensate. It works for me. If you have a positive outlook on getting a hysterectomy, it can work in your favor. Remember there are many solutions to the side affects and most women do not have major problems after menopause, particularly if they pursue trying to solve problems as they arise. I would look at this as something positive, that will enhance rather than detract from your sex life.
Regards,
Sharon

[BnSinbville]

S, thanks for writing me! You say the last "bits" of your ovaries were removed. They were partially removed before this??


TS- I'd had parts of both removed when I was 13, I had cyst on each.

Wow, it's great to hear all of this! Did you not have mood swings, no hot flashes, none of that?

NO, no mood swings, no hot flashes, no night sweats...none of it and I don't have migraines any more either!

I'm so sorry for your loss, and what timing. It must have been awful for you.

Thanks, it was pretty tramatic, but we knew he was dying and I knew sooner or later that I would have to have the surgery...just not then


Glad to hear your Dr. is a woman, they understand what you are going thru. They also are better at alternate options than a man.

recovery was pretty fast.. I had surg on Wed, came home on Fri and walked 300 yards to the mail box on Sat. (very slowly) As for sex... I was all but attacking one of sons friends on New Years Eve!!! LOL found out I like that young stuff!!! I think all in all sex is better, don't have to worry about periods and with fibroids at times it could be uncomfortable...great now. Orgasms are better for me!!! Doesn't take long for self-lube either...just that thoughts of sex can have me warmer and wet.

I could have gone back to work the begining of Dec (6 weeks) but decided to take more time off due to all the emotional stuff I was going thru after losing my husband of 29 years. I was running a gauntlet of emotions including feeling guility that is was over..so that was a different thing than the hysterectomy.

Are you going to have an incision or do the surgery vag? I have a hugh scar from my belly button to my pubic bone. But that is how they did the surgery years ago the first time. Today they do a tiny little cut like a bikini line, due to the other surg I couldn't do this and the fact that I am a PLUS SIZE BARBIE!!!

If I think of anything else I'll let you know....just walk, walk, walk!!!

Hugs from the Heart......... S

[Tybee Swing]

Originally Posted by NJCouple

I have had no problems with lubrication, desire, feeling etc. If anything our sex life is so much better. There is no concern about pregnancy and not getting my period is wonderful! I actually feel kind of smug when other couples' play time is cramped by "that time of month."

I know that feeling. When two couples with two menstruating women are trying to syncronize our play schedules, it can be tough! We've had to be on the sidelines at what would have been fun parties or weekends, if not for Aunt Flo accompanying us.

Originally Posted by NJCouple

It makes me feel more of a woman as I can please my husband without having these concerns. I think a lot of the lack of desire is in the mental attitude and so I chose my unusual outlook to compensate. It works for me. If you have a positive outlook on getting a hysterectomy, it can work in your favor. Remember there are many solutions to the side affects and most women do not have major problems after menopause, particularly if they pursue trying to solve problems as they arise. I would look at this as something positive, that will enhance rather than detract from your sex life.
Regards,
Sharon

I agree, mental attitude can go a long way. Thanks for that. I've heard, and know some people personally, with scary stories. I'll try to look beyond that and try to keep my own experience as positive as possible. I'm definitely not the kind to give up if I run into trouble; I keep chipping away until I get a resolution. I'll remember what you said.

I looked up your Activella hormone replacement. I see it's plant-based (not that horse urine stuff). I like that, and I like that you say it's low-dose. I'm going to ask my doctor about that.

Hugs and thanks!

[lovinher]

We will most likely be in your position in the future and the same fears have been discussed so I'm looking forward to some of the responses here.
Best of luck to you Tybee Swing. Make sure you let us know how things go!

[Tybee Swing]

Originally Posted by lovinher

We will most likely be in your position in the future and the same fears have been discussed so I'm looking forward to some of the responses here.

You're so right. One way or the other, whether naturally or surgically, all of us have to go though this sooner or later...and our husbands along with us!

Originally Posted by lovinher

Best of luck to you Tybee Swing. Make sure you let us know how things go!

Thanks. Actually, I have an update already!

I am fighting to keep my cervix and uterus, which are actually apparently quite healthy (and like I said, no history or serious concerns about cancer). My doctor had her reasons for wanting it all out (erring on the side of caution). I have many reasons for wanting to keep those, including my orgasms!!! I'm one of those women that is very multi-orgasmic, orgasms easily, and has those very deep "vaginal" orgasms with no clitoral stimulation needed. Those "vaginal" orgasms are in reality, much deeper than that...it's really the uterus and cervix that are involved in those! Take those away from me and I WILL be a different woman, sexually. It's one of my risks. Other risk factors are very unsexy things like urinary and/or bowel incontinence, and a higher risk of those parts prolapsing....dropping. UGH!

After I explained my sexuality in great detail, how my husband and I fit now and what I stand to lose in the fit department if my cervix is cut out, top of the vagina sewn shut (making vaginal canal shorter and smaller), etc. etc., she really heard me. She acknowledged that my type (orgasmically) isn't the norm, and she understands what I'm telling her. About the fit, I'm already tight and my husband is hung big. We already have to work things in and he already has to be careful to not bang anything in there. If things were smaller/shorter, he might possibly not even be able to fully enter me or ever really "thrust" in me again. My orgasms could be "killed" or greatly diminished. It would be a huge and very heartbreaking loss for us, if all this stuff happened to us. I was communicating everything I could, so we'd be taken for the individuals we are, and everything considered! My doctor now knows more about us sexually and biologically than most of our swing friends do. LOL! I even gave her my husband's precise measurements so she would GET what it is I'm working with, here! She got it. I WON!

We agreed that unless the immediate pathology (giant cyst sent to lab while I'm still under) comes back with bad stuff, my cervix and my uterus will STAY!

The surgery I'm going to have now is actually not a hysterectomy (removal of uterus), but actually called an oophorectomy (removal of ovaries and fallopian tubes). Plus, the removal of this 8" cyst. This means I still will go into instant surgically-induced menopause with the loss of the ovaries, but I can deal with that. She and I had a good conversation about combinations of low-dose hormones, etc.

In case anyone's interested in the connection between hysterectomy (uterus/cervix removal) and the deep-down orgasms that some women have, here's some of the medical data I collected and used as my "ammo" with the doc:

From WebMD article (link below) -
"A subtotal or partial hysterectomy removes the uterus above the cervix but leaves the cervix intact. Fewer nerves are severed during this procedure, so the bladder, bowel, and sexual functions aren't as damaged."

possible sexual complications from hysterectomy:
"Decreased pleasure during orgasm: Orgasm can result from stimulation of the clitoris, uterus, or both. Pressure on the cervix, the uterus, and its surrounding ligaments and membranes can heighten an orgasm.

Diminished sex life: Some women find that a hysterectomy increases their quality of life, leaving them free from bleeding and pain that can dramatically affect their sex life. Unfortunately, the majority of women report their sex life diminishes after a hysterectomy, largely due to the effects of surgical menopause, which can reduce vaginal lubrication, but also because they lose some sensation during intercourse involving the penis's pressure on the cervix, the uterus, and surrounding ligaments and membranes, which for some women can produce an intense and pleasurable orgasm that is different than simple clitoral stimulation. Women who experience primarily clitoral orgasms may not experience a difference in their sex life. Intercourse can also be affected if the vagina has been shortened during surgery; in this case, scar tissue may form in the vagina or pelvis, resulting in pain during sex."

If interested, here is the complete article from WebMD: http://www.webmd.com/content/article/85/98743.htm

From another WebMD article: "For some women, sex after hysterectomy -- removal of the uterus -- can create loss of sensation -- loss of intense female orgasms, Berman explains. If women don't have severe pelvic pain or bleeding, or cancer, they should look at other options to hysterectomy," says Berman."

"Female orgasms involving deep pelvic contractions -- "vaginal orgasms" -- may be affected by loss of sensation after hysterectomy, she tells WebMD."Those women will still have clitoral orgasms, albeit less intense and less satisfying, they won't lose that ability altogether."

The complete article: http://www.webmd.com/content/article/74/89383.htm

[Tybee Swing]

Originally Posted by BnSinbville

Are you going to have an incision or do the surgery vag? I have a hugh scar from my belly button to my pubic bone. But that is how they did the surgery years ago the first time. Today they do a tiny little cut like a bikini line, due to the other surg I couldn't do this and the fact that I am a PLUS SIZE BARBIE!!!

If I think of anything else I'll let you know....just walk, walk, walk!!!

Hugs from the Heart......... S

S, thanks again!

To answer you, I cannot have it vaginally removed (much quicker recovery with that; wish I could). I have to have it abdominally removed, because this cyst is so big.

I already have a low bikini line scar that's only 11 months old...this is from my extensive around-the-world lower body lift (including a tummy tuck with ab muscle repair), which I had after completing weight loss. I have LOVED this tummy, and I worked so hard to get it. I don't want to lose it.

However, due to the size of this cyst, my doctor may have to go beyond the horizontal bikini cut and go UP my pelvic area with a scar (like an inverted "T"). Worst case scenario, above my navel. This would be heartbreaking for me, after all I've been through to finally have this smooth, flat belly. She knows all about my surgery, my weight loss before that, and all of it. She knows that I want her to do everything in her power to not cut up my abdomen. She promised she will try. She said she'll get an associate surgeon in there with her to try to work this cyst out through the bikini line - but they can't risk bursting it, either.

If I'd had this cyst before my tummy was fixed, it would go much easier for her. As it is, my abs are very tight (also due to the fact that I work out a lot, plus the surgical fix), and the skin of my belly is tight, too. If everything was still all stretched out like it was before, she could move around in there a lot easier.

I asked her if she can patch up my abdominal muscles as brilliantly as my plastic surgeon had done; she said that should be no problem. With a lot of luck, maybe my tummy will stay looking like it does now (but without the distention from the cyst, of course). I hope and pray...and I'm crossing everything for that!

[BnSinbville]

TS, I have no doubts that you will come thru this wonderfully.. you are very fortunate to have such a great doc. It sure pays to do your homework, which it sounds like you did. Thankfully you don't have to go thru this alone...good luck to you and hubby getting past all this. S.

[M and H]

Hi Tybee Swing,

I reached menopause naturally but very quickly (regular periods one month & then "poof", no more periods). As a result, I didn't go through long periods of mood swings due to fluxuating hormones, but instead went straight to the "virtually non-existant sex hormones" phase - also called post-menopause.

The fact that I went from pre- to post- menopause so quickly, I thought my experience may be very similar to what you might go through with your ovaries being removed so here's my story ...

The biggest changes I noticed after menopause were dryer skin and wrinkles, almost non-existant vaginal lubrication, lower libido and less able to orgasm even when aroused (not that I ever had a high libido or was ever able to orgasm easily, but it was noticeably lower, which was even worse), and abnormally early and rapid onslaught of osteoporosis.

I was put on estrogen (estradiol in the form of a once a day pill), progesterone (a Meridian intrauterine device with a 10 year lifespan) and testosterone (a large pea-sized squirt of Androgel transdermal gel once a day).

I've been on that combination for about a year now and although my skin is still dry and wrinkley (particularly on my hands), my vaginal lubrication is even better than it was before I reached menopause, my libido and ability to orgasm (I call it a functioning "trigger") are slightly higher/easier than before, and the onslaught of osteoporosis has virtually stopped.

Just a note about testosterone for women ... although many doctors won't prescribe it for women because of the risk of unwanted and irreversable effects and because they haven't done enough research on the long-term affect of synthetic testosterone on women, testosterone is an important part of the sex hormone trio. The problem is, we need far less and are way more sensitive to its effect. All the testosterone-related effects such as increased libido, increased ability to orgasm, increased aggression, increased facial/body hair, lowering of the voice, and increased clitoral size are VERY closely related to how big a "pea-sized" squirt of Androgel you use, and if you take too much, some of the effects, such as a lower voice and an enlarged clitoris, are not reversable on reduction of the dose. Unfortunately a higher libido and the ability to orgasm easily IS a reversable effect, lol.

I don't know if any of this will help you, but hopefully you can get something out of it ... I feel for you ... after having gone through so much to get yourself in the shape you're in now, I'm sure you're torn between wanting to maintain yourself as close as you can to your new self and wanting to do what you need to do to be healthy and live a long life.

Good luck to you ... HUG!!

M (of M&H)