THE EFFECT OF HYSTERECTOMY AND OOPHORECTOMY ON
THE IMPACT OF HYSTERECTOMY VERSUS OOPHOROHYSTERECTOMY
ON WOMEN’S SEXUALITY
by Elizabeth Plourde, Ph.D., C.L.S.
Objective: To determine if there are differences in overall sexual function between women who have a hysterectomy-only compared to women who also have their ovaries removed at the time of hysterectomy. If there are overall differences, to determine the subscale aspects of sexual functioning involved, and whether women’s level of interest in sex before surgery influences sexual functioning outcomes.
Materials and Methods: A total of 50 women, 25 hysterectomy only and 25 oophorohysterectomy, who were operated on for benign gynecological conditions and were not menopausal at the time of surgery, were enrolled in this retrospective study. The Changes in Sexual Functioning Questionnaire–Female (CSFQ-F) and the Sexual Response Questionnaire–Hysterectomy (SRQ-H) were completed in a self-report format by participants.
Results: ANOVAs detected statistical differences between groups in total sexual functioning scores after surgery, and within the subscales of pleasure, desire/frequency, desire/interest, and orgasm/completion. The subscale of sexual arousal/excitement did not reach a statistically significant difference between groups, but approached significance. The hysterectomy-only women had statistically significant higher scores in strength of sex drive, overall sexual satisfaction, and in the number who were orgasmic compared to the oophorohysterectomy women.
Conclusion: Ovary removal at time of hysterectomy was found to be associated with overall decreased sexual functioning compared to hysterectomy-only. Women should be advised that ovary removal led to significant differences in total scores, and in 4 of the 5 sexual functioning subscales measured in this study. The potential for decreases in sexual functioning should be discussed and reviewed when recommending prophylactic ovary removal.
(from dissertation text)
The majority of studies investigating sexual functioning following hysterectomy published to date have not focused on examining the differences between how women respond sexually with and without ovarian function. There has also been little focus on whether the ovaries remain functional and produce hormones at optimal levels after a hysterectomy, creating some variability in sexual functioning. The lack of clear demarcation of ovarian function could be one reason for the lack of significant findings in previous studies. By identifying and eliminating the hysterectomy-only women who experienced a decrease in ovarian function after surgery, this study detected significant differences between women with hysterectomy-only and those with oophorohysterectomy in total scores and four out of the five subscales of sexual functioning with the CSFQ-F questionnaire. Utilizing the SRQ-H questionnaire, significant differences were detected across all aspects of sexual functioning measured. This study’s findings revealed decreased sexual functioning in women with oophorohysterectomies compared to women with hysterectomies. More women in this study had an average or high interest in sex compared to the general population. This finding may indicate that these women are impacted more severely because ovary removal results in a decreased ability to function sexually.
The extreme outcomes that appear throughout the medical literature were replicated in this study. The complexity and multifaceted nature of the human sexual response is demonstrated by the fact that not all the women who had their ovaries removed lost their interest in sex or ability to respond sexually, and not all of the women who retained their ovaries maintained their sexual functioning. These conflicting results indicate there are other factors that influence sexual functioning and need further research.
A clearer determination of the origin of women’s sexual responses, in conjunction with a better understanding of what constitutes women’s sexual function and satisfaction, need to be developed and incorporated in the future studies. More research needs to be conducted to confirm these findings and to identify other possible causes for improvement or deterioration in sexual functioning following ovary removal. The profound loss women expressed in this study, as well as the problems created within their relationships that arise from deteriorations in sexual functioning, necessitates this area be explored more rigorously before more women face the decision of prophylactic ovary removal with a hysterectomy.
This work is © 2005 copyrighted and unpublished.
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