Some medical problems may require a woman to undergo a hysterectomy (his-tuh — hysterectomy
REK-tuh-mee), surgical removal of the uterus, or an oophorectomy (oh-uh-fuh-REK — Surgical removal of the uterus.
tuh-mee), surgical removal of the ovaries, or both. Such problems include bleeding °°Phorectomy
Surgical removal of the ovaries.
disorders, severe pelvic infections, and the presence of benign (noncancerous) tumors (Kilbourn & Richards, 2001). Cancer of the cervix, uterus, or ovaries is also cause for hysterectomy or oophorectomy.
Of these three cancers, ovarian cancer is by far the deadliest (Torpy et al., 2011).
In about 80% of women with ovarian cancer, the disease is advanced when diagnosed (Kaelin et al., 2006). The cancer is difficult to detect in its early stages because the symptoms are often similar to those caused by other problems (Eheman et al., 2006). The following symptoms may indicate ovarian cancer if they appear daily for three weeks:
Abdominal pain or bloating, pelvic pain, difficulty eating or feeling full quickly, and frequent or urgent urination (American Cancer Society, 2009).
In the United States, approximately 600,000 women have hysterectomies each year (Tucker, 2010). An estimated 33% of women have a hysterectomy by age 65, making it the second most frequently performed major operation for women in the United States (Gretz et al., 2008). Hysterectomy rates are higher among low-income women, women with less than a high-school education, and women who live in the South. Researchers suspect that a lack of preventive health care in these groups allows problems to advance to the point where other treatments are not viable (Palmer et al., 1999). Before consenting to undergo a hysterectomy or similar surgery, it is important for a woman to obtain a second opinion; to fully inform herself of the benefits, risks, and alternatives to surgery; and to arrange for thorough preoperative and postoperative information and counseling (Pearson, 2011).
The effects of hysterectomy on a woman’s sexuality vary. Hysterectomy does not affect the sensitivity of the clitoris. Some women find that the elimination of medical problems and painful intercourse, assured protection from unwanted pregnancy, and lack of menstruation enhance their quality of life in general and their sexual functioning and enjoyment (Flory et al., 2006). An important variable in postsurgical sexual adjustment is the degree of satisfaction with the sexual relationship prior to surgery: If a woman had low sexual satisfaction prior to surgery, the surgery is much less likely to have a positive impact on her sexuality (Lonee-Hoffman & Schei, 2007).
However, other women experience an alteration or decrease in their sexual response after removal of the uterus. Sensations from uterine vasocongestion and elevation during arousal as well as uterine contractions during orgasm are absent and can change the physical experience of sexual response. Some changes can result from damage to the nerves in the pelvis. The exact locations of nerves vital to female sexual function have not been identified, and no nerve-sparing procedures are done during pelvic surgeries in women (Berman & Berman, 2005). Scar tissue or alterations to the vagina can also have an effect. When ovaries are removed, symptoms common to menopause will occur unless hormone therapy is undertaken.