Ask the Doctors: Enjoying Sex Post-Hysterectomy

Dear Dr. Queen,

I am a female 65 yrs. Young and had a  complete hysterectomy in  1987.  Of course, you already know I lost everything that makes me want sex.  I had to fake it.  In the last few years, I learned that I can stimulate my clitoris and claim some victory with use of a vibrator.  Can I receive same outcome using the anal Peridise toy?  Thank you so much for your help.  I really need to fix my problem.  I want to still enjoy sex anyway I can.

– anonymous

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First, a complete hysterectomy sometimes — though not always — does make women lose touch with their sexuality, as happened to you. The main culprits here seem to be the very abrupt change in hormones experienced as a result of the loss of the ovaries, and for women who liked intercourse, the surgery can really alter that sensation because the uterus is removed and, often, nerve damage ensues. But every woman undergoing a hysterectomy ought to discuss sexual changes with her doctor (though regular readers have heard me say many times that most docs don’t have sex knowledge that is as thorough as it should be). And every doctor ought to know (and share with patients) that there are two neural paths to orgasm, and the clitoral one is not as likely to be damaged by this surgery as the other, which tends to enervate the vagina, g-spot, and cervix. Thank goodness you discovered this yourself.

Anal play may indeed give you a lot of pleasure, and the Peridise is a great toy to start with. It’s designed not only to give the sensitive nerves around the anus some stimulation, but also to allow you to exercise the muscles of the pelvic floor — this is definitely good for you to do post-hysterectomy. There are vaginal toys you can use the same way, like Betty’s Barbell — in both cases you are using the toy to tone the pubococcygeus muscles, which are the muscles that pulse or clench when you orgasm. One very common source of sexual problems in women, especially post-menopausal women, especially those who have become sedentary, is the decreased pleasure orgasm brings when these muscles are not in tone. Plus if you choose the Peridise, you get the added plus of anal stimulation, whether or not you choose to add other anal penetration or intercourse to your repertoire.

If you decide to explore this toy (or other sources of anal stimulation), here are a few more thoughts. One, don’t forget to experiment with clitoral and anal stimulation together. Many women find this an extremely powerful erotic combination, and if that is true for you, you will go some way toward regaining your enjoyment of sexuality. Second, lube. For any anal penetration, lubrication is a must — you might find you prefer thicker water-based lubes, or one of the newer super-slippery silicone lubes. Since the hysterectomy threw you into abrupt menopause, you’ll probably appreciate lube for anay vaginal play you engage in, as well. Finally, if you are going to have anal intercourse with any men (unless you are fluid-bonded with a partner), don’t forget the condoms. In fact, if anal intercourse is in the cards, I would definitely recommend reading up on this type of play via Jack Morin’s terrific book Anal Pleasure and Health or one of the other anal how-to books now available; if you want to wait a couple of months, I’ll also have an educational movie out about anal play, available at Good Vibrations.

Finally, a few thoughts about sex post-hysterectomy: You don’t say whether your experience included simply a change in the way vaginal penetration felt to you — actually, “simply” is not really the word I should use here, because when this happens to you, it is far from simple. Many women who’ve had hysterectomies report this effect at least, in addition to any post-surgical libido effects they feel. (Many surgeons are now trying to perform this surgery without removing the entire uterus, since there is some evidence that retaining the cervix is important to many women’s sexual experience. Of course, how much or little nerve damage the surgeon did is also an extremely important question.) But the other possibility — I’m not sure whether or not I read this between the lines of your letter — is that pain is an after-effect, at least for a while. Continued pain shouldn’t be a result of hysterectomy, and if it is, you should talk to your doctor.

For some women, it’s possible (especially adding in other, new sources of stimulation) to get to a place of pleasure with vaginal penetration post-hysterectomy, though you do generally have to deal with the fact that your sensations are different than they were before. The most important thing is that you care about sexual pleasure, which certainly gives you an advantage — and the means to explore your erotic possibilites even in the face of this change. The good news is, there are so many sensitive areas on your body, it could take most of the rest of your life to find them all and discover how much pleasure they can give you. Best of  luck!

–CQ

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