Does a hysterectomy change sexual feeling? | CION Cancer Clinics

For most women, no. The parts that give sexual feeling, the clitoris, the outer lips and the lower vagina, are not touched by a hysterectomy. Once the wound inside has healed, most women say sex feels the same as before, and some say better, because the bleeding, pain or worry that led to the operation has gone.

Why some women do notice a difference

A hysterectomy for cancer is not always a simple one. If your ovaries were removed too, your body stops making oestrogen, the hormone that keeps the vagina moist and stretchy. Dryness is then the most common reason sex feels different. In a radical hysterectomy for cervical cancer, the top of the vagina and some nerves beside it are removed with the womb, which can change deep sensation for a while.

What the womb itself was doing

During orgasm the womb tightens along with the pelvic muscles. A few women were aware of that and miss it. Most were not.

When sex feels different after a hysterectomy, there is nearly always a reason that can be named, and most can be helped.

Dryness and thinning

Low oestrogen makes the vaginal lining thin and dry, so friction hurts and feeling is dulled. A water-based lubricant and a regular moisturiser help most women. A low-dose oestrogen cream placed in the vagina helps more, but whether it is safe depends on your type of cancer. Ask your oncologist first.

Fear of hurting something

Many women, and many husbands, hold back because they fear the inside will tear or the cancer will be disturbed. Once your surgeon has said the cuff has healed, neither happens. Fear tightens the pelvic muscles, and a tight pelvis is what hurts. A pelvic floor physiotherapist can teach you to relax them.

Tiredness, mood and the body you see

Desire is the last thing to come back after cancer treatment. It follows sleep, energy and feeling like yourself. Chemotherapy on top of surgery pushes it further out.

This page cannot tell you what your own operation removed, or whether the nerves beside your vagina were cut. Only your surgeon can. Nor can it say whether a hormone cream is safe for you.

Questions worth asking at your next visit

Ask whether your ovaries were removed. Ask whether the operation was simple or radical. Ask when the cuff will be healed enough for sex, and whether you may use a vaginal oestrogen product. If radiotherapy is planned, ask about dilators before it starts. Write the answers down.

Who can help beyond the surgeon

A pelvic floor physiotherapist helps with pain, tightness and the fear that goes with them. A counsellor helps when the problem is desire, mood or how you feel about your body. Bring your partner if you can.