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Feeling Frisky?

Some women find that in the weeks following surgery they are consumed with a new or increased sexual desire. This increase in libido can be brought on by the sudden hormone changes in your body. If you kept your ovaries, libido may depend on how well the ovaries are working. If you had your ovaries removed, you could have stored hormones in your tissues until they are played out. After that, your hormone therapy will have much to do with your libido. It is a very nice surprise, especially if libido had been lacking pre-hyst, but don’t be surprised if it fades as quickly as it came.

How to Talk to Your Doctor about Sex

Most women are hesitant to talk to their doctor about sex and resuming intercourse. Asking your doctor ahead of time what to expect, and what to do if you run into problems (pain or bleeding) might help to calm your fears about resuming sexual activity. Don’t let embarrassment stop you; the risks of not talking about your concerns far outweigh the uneasiness you might feel.

There are some things you can do ahead of time to make this discussion with your doctor easier:

  • Make a list of your concerns. Write them as questions and make them as brief as possible.
  • Talk to trusted friends who respect your privacy and share common concerns may help you get an idea how others feel and what their experiences have been. Do this only if you are comfortable with the idea.
  • If you have specific areas of concern, do some research ahead of time. You’ll have a better understanding, and can start the conversation sharing what you have learned, and ask for your doctor's opinion or more information.
  • Getting started on a sex discussion with your doctor can be hard because you may feel rushed, or there may not be an obvious opening to talk about sex. Don’t be intimidated! If you have your questions ready you can get through it quickly and you will have peace of mind when you leave the office. Also keep in mind your doctor could possibly be uncomfortable too. Doctors, like anyone else, could feel awkward talking to you about sex. If you anticipate this possibility, you will be less likely to be thrown off if it happens.

    Waiting for Doctor's Clearance

    It’s very important that you wait until you have your doctor’s clearance to resume intercourse. This is usually given about six weeks after surgery. Some women won’t heal sufficiently to have sex safely at this point & the doctor may prescribe a longer period of restriction. Tissue that isn’t sufficiently healed can tear or become infected, which could lead to complications requiring further treatment. This is why absolutely nothing should be placed in the vagina (douche, vibrator, fingers or other body parts) until you have been released by your doctor. Anal sex is also on the list of restrictions, since your pelvic area needs to rest & recover. Ultimately, the 6 weeks no-sex rule is a very small timeframe in the big scheme of things. You deserve to have a smooth & uncomplicated recovery!

    Self-testing or Masturbation

    Some women have no partner, or are anxious to be certain everything is working properly before they are released for sexual intercourse. Many women want to know if it is safe to have an orgasm before they are cleared by the doctor (as long as there is nothing inserted in the vagina).

    It is recommended that women speak to their doctors before they resume any kind of sexual activity. An orgasm causes increased blood flow to the healing tissues or spasms that could cause damage depending on what type of surgery you had and how well you are healing at the time. Doctors' opinions differ on this, and it is always best to check with your own doctor to make sure it is safe for you.

    Outercourse

    Outercourse refers to sexual activity that doesn’t involve anything being inserted in the vagina. Some women are comfortable with using a vibrator to stimulate themselves to orgasm. Other women desire the closeness with their partners. As long as there is no penetration and your doctor says ok, manual stimulation can be safely done.

    Being Emotionally Ready to Resume Intercourse

    Once you are released by your doctor for sexual activity, it’s important to be emotionally ready. Just because the doctor says you can doesn’t mean you are emotionally ready. It’s important to recognize all aspects of this surgery & recovery. Because the reproductive organs are affected, there can be a wide range of thoughts and feelings associated with resuming intimacy once you have been cleared by your doctor. It’s ok and even smart to acknowledge your fears and to share them with your partner. It will be much easier for both if you have open and honest communication. Your husband or partner might be fearful of hurting you and/or have other fears to discuss. Love and respect on both sides will make this big step in your recovery one that both of you can be comfortable with.

    Lubricant & Where to Get It

    Many women choose to use personal lubricant to assist in their initial post-op sexual activities. Lubricants are available online, or anywhere that feminine products are sold, usually displayed in the same aisle as condoms. Popular brands include Astroglide, KY Jelly, and available in the HysterSisters Store: Very Private Daily Intimate Moisture. Ordering online is convenient and confidential.

    Intercourse After Doctors' Clearance

    It’s a good idea to have personal lubricant on hand, even if you haven’t needed it in the past. The pelvic area could be tender and the extra moisture can help reduce stress on those tissues. Remember that your body is still recovering and it might be a good idea for you to be in control of the action; many women report that being in a sexual position on top gives them better control. Plan to take it slowly and gently on those first attempts. You may find you will have some soreness afterwards, but some women do great with no problems. With practice and patience, most women return to a very satisfying sexual experience. Those who had pain prior to hyst often find that post-op sex is much better than they have experienced in a long time.

    Vaginal Length & Well Endowed Partners

    The average vagina is about 3 inches long, and will relax and elongate with sexual arousal. A hysterectomy may shorten the vagina slightly, but remember: the vagina is elastic enough to hold a tampon or pass a baby, so there should be no post-op size issues even with a well-endowed partner.

    Oral Sex

    There are differing opinions on being on the receiving end of oral sex as an early post-op patient. The universal rule of nothing in vagina still applies, and with oral sex, there is the danger of introducing bacteria into the vagina that could cause infection. Please check with your doctor if you have any concerns about this during your early post-op weeks.

    The G Spot

    The “g spot” is not a medically-recognized term for any part of the female anatomy, but the term has taken hold in the general public, and many women talk about there being an area that is particularly sensitive that provides intense sexual excitement through stimulation. Medical researchers are left to debate what this subjective experience that many women have is, what the origin of the excitement is, and where it fits into the larger picture of female sexual anatomy and health.

    All women have a g spot, but not all women notice anything different when it is stimulated, and some actually dislike the sensation. So, don't be discouraged if you can't find your own; there is nothing wrong with you, and what turns us all on is incredibly individual and unique.

    The G spot is located in the front or anterior wall of the vagina, and if your hyst includes anterior or posterior repair, some cutting may be done nearby. The g spot can be located by inserting a finger, palm side up, and making a "come hither" motion with the finger.

    This is for information only and not endorsement for anything to be inserted into the vagina without clearance by your personal physician.



    HysterSisters
    Female Sexual Disorder and the HysterSisters

    While there is little information written specifically for women who have had a hysterectomy and experiencing sexual dysfunction, the goal is to collect information and provide it to the HysterSisters.com community.

    Female Sexual Dysfunction (FSD)

    Female Sexual Dysfunction (FSD) is characterized in ways both physical and emotional/psychiatric. FSD is not only complex in its definition, it seems to become more complicated with the added experience of the woman who has had a hysterectomy with loss of ovaries through removal, chemotherapy, or loss of function (for those retaining ovaries) from the surgical experience.

    Sexual dysfunction within the HysterSisters community is observed as a post-op experience, usually many months post-op. It is also noteworthy that experiencing FSD is a surprise to the woman who has experienced a hysterectomy and who was previously enjoying a satisfying sexual relationship with her husband of many years.

    Whether a HysterSister is in her 20's or her 60's, the report of distress over sexual dysfunction spans the age brackets. Researchers tell us that about 50% women surveyed feel that a satisfying sexual relationship is important to their quality of life. Distress is reported by those HysterSisters whose Female Sexual Dysfunction has interrupted that enjoyment.

    There are four main categories of FSD:
    Hypoactive Sexual Desire Disorder (HSDD)
    Female Sexual Arousal Disorder (FSAD)
    Female Orgasmic Disorder
    Sexual Pain Disorders

    Talk to Your Doctor About FSD

    If you find yourself distressed and concerned about your sexuality, its important to schedule an appointment with your physician. While sexuality may not be an easy topic of discussion, its very important. Share your struggle with your physician. Without your persistance there can be no treatment.

    Below are some ideas to consider as you prepare for that appointment.

  • Educate yourself.
  • Read books and articles to better understand what to ask your doctor.
  • Initiate conversation.
  • Don’t expect your doctor to specifically ask about your concern.
  • Take a helpful article.
  • "I was reading this book/article and wondered what you thought about it."
  • Prepare a discussion starter.
  • "I was hoping that you might be able to help me with this problem I am having."
  • Acknowledge the subject.
  • Discussing sex can be embarrassing or uncomfortable but you need medical direction for treatment.
  • Be specific.
  • Be sure and use an accurate description of the problem and appropriate vocabulary.
  • Persist.
  • "If you can't help me with this, who would you recommend?"
  • Share information.
  • If you've heard of a potential treatment, provide the information to your doctor. This is especially helpful if the information is based on research and already accepted in the medical community.
  • Bring your spouse or a friend.
  • Sometimes it might help you to bring someone with you to your appointment. It can possibly help to provide support for you.
  • Ask for additional time.
  • If you find the doctor doesn't seem to have adequate time for a discussion, ask for additional time. Or ask if you need to make another appointment for a longer time slot.
  • After your appointment.
  • If you are unsatisfied with the discussion with your doctor, don't stop there. This will take effort on your part. Don't give up!
  • Keep Looking.
  • Look for a physician who will listen if you are not satisfied with the discussion during your appointment.
  • Ask for physician referrals.
  • Friends and family may have referrals for you to consider. Especially keep an ear out for friends who may struggle from similar concerns.
  • "Interview" several/many doctors.
  • It may take you several doctor appointments before you find the physician that you feel most comfortable and is most helpful.

    Pain During Intercourse - Post Hysterectomy

    Pain during intercourse (also referred to as dyspareunia) is defined as pain or discomfort in a woman's labial, vaginal, or pelvic areas during or after sexual intercourse.

    There are many other reasons for painful intercourse, including Endometriosis, adhesions (scar tissue), interstitial cystitis (a bladder condition), and ovarian cysts. Infections also can cause discomfort at the vaginal opening. A weakening of the supporting structures such as a bladder prolapse (cystocele) or Uterine prolapse can also cause discomfort or even pain during intercourse.

    The top 5 leading causes of pain during intercourse are the following:

    Hormones:
    Natural or surgical menopause can result in sexual discomfort due to hormonal changes. Decreasing levels of Estrogen can dry up our bodies own natural lubrication and leave vaginal tissue dry and fragile. Over the counter Lubricants often provide temporary relief. The use of an Estrogen cream or other Hormone Replacement Therapy can provide a more permanent solution.

    Vulvodynia:
    A condition in which part of the vulva is chronically inflamed. It can cause a burning pain at the opening of the vagina. It can often make intercourse near impossible due to the severity of pain experienced.

    Cutting out certain foods has shown beneficial to many woman as has decreasing/controlling muscle spasms through the use of a biofeedback device, that may be contributing to the pain. As a last resort, surgery to remove the chronically inflamed skin has helped some woman but should be considered only after more conventional treatments have failed.

    Interstitial Cystisis (IC):
    A chronic inflammation of the bladder that can lead to severe pelvic pain. It is often described as feeling as if you have a UTI but antibiotics fail to provide relief.

    The pain with this condition usually increases during intercourse.

    There are variety of treatments, sufferers usually can find relief through one of them.... no single therapy seems to work for everyone.

    Deep penetration often causes the discomfort with IC, avoiding this may help.

    Endometriosis:
    A condition, that can be extremely painful, leaves tissue from the lining of the uterus to grow into other areas such as the vagina or pelvis where it becomes inflamed. Pain with intercourse is reported by more than half of the woman suffering this condition.

    Birth control pills, drugs that temporarily suppress estrogen production or surgery to excise the tissue can often bring many relief. Some find that limiting intercourse to the week or two after your cycle may help minimize the discomfort.

    Infection:
    Sometimes the first sign of an infection can be pain during intercourse. Lubrication can be reduced by yeast and bacterial infections. This can result in the irritation at the opening of the vagina, itching, unusual discharge or odor is usually accompanying. A urinary tract infection will hurt most when you urinate but can also cause pain during intercourse because of the pressure on a tender, inflamed bladder.

    Once infections are diagnosed, most are easily treated with antibiotics, pills or with yeast an antifungal cream.

    When to seek treatment:
    Any new or worsening pain, bleeding, or discharge following intercourse should always be reported to your health care provider.

    Generally, pain with intercourse is not an emergency. It is a condition most appropriately checked by a group of specialists including your Gyn.

    Any of the following symptoms should be checked immediately at the nearest ER:

  • New onset of pain or pain more severe than previous episodes and that lasts more than just a few minutes
  • Any bleeding following pain, particularly new or severe pain
  • Nausea, vomiting, or rectal pain following intercourse
  • Resources related to above:

    Painful intercourse (dyspareunia): http://www.netdoctor.co.uk/sex_rela...intercourse.htm

    Pain during Sex - Five Common Causes: http://www.allayurveda.com/pain_during_sex.htm

    What is Dyspareunia? http://www.inletmedical.org/html/dyspareunia_causes.htm

    Pain During Intercourse: http://www.emedicinehealth.com/articles/6736-1.asp



    HysterSisters
    Resources

    Read on for articles, discussions and links to help you gather more information about post-op intimacy.

    Resources

    Post Op Discussions

    Post Op Articles

    Post Op Resources

    Post Op Checkpoint 1-2

    Post Op Checkpoint 3-4

    Post Op Checkpoint 5-6

    Post-Op Sexual Dysfunction Discussions

    Link Resources

    Intimacy Articles

    Articles
    Latest Discussions in the Sexual Dysfunction Forum
    • Bloom study, no interest and lack of libido help
    • found this forum last night. i was looking for info on the "Bloom Study". I had my first appointment today and made it through all the medical history, BMI and vitals. But they gave me a series of words or phrases to rate from 0 to 3. The words were: ... [Read More]

      Posted by hvar

      02-01-2010 - 02:42 PM
       
    • Orgasms weaker and difficult to achieve
    • Wow, I too can't believe this has happened to me. Very difficult to reach orgasm, and when I do it essentially lacks the contractions or if they are there they are weak and brief. Sooo disappointing. My fist anniversary will be April 1st - TAH. I am ... [Read More]

      Posted by jani2

      01-31-2010 - 11:32 PM
       
    • Absolutely no sexual desire
    • Absolutely no sexual desire.....not too good with husband.
      Wonder how much longer he'll accept this lifestyle - my lifestyle.... ... [Read More]

      Posted by ob1canobee60

      01-30-2010 - 11:39 AM
       
    • bloom study
    • I am awaiting my consent form for the Bloom Study. Are anyof you participating in it? I saw the ad on TV, went to their website (bloomstudy.com) and the next day got a call from our local clinic. sounds great so far, just awaiting the paperwork for ... [Read More]

      Posted by saloncuts

      01-29-2010 - 02:34 PM
       
    • Short Vaginal Cuff
    • When I had my hysterectomy I was married. To my absolute shock I was too short for sexual intercourse to be anything but painful. I felt like I was being hit by a battering ram. Let alone him complaining about not being accommodated as he had been ... [Read More]

      Posted by Peaches11

      01-25-2010 - 08:37 AM
       


    HysterSisters
    Hints from the HysterSisters

    Read on for articles, discussions and links to help you gather more information about post-op intimacy.

    Hints from the HysterSisters

    When you’ve been cleared by your doctor and you both are ready, take time to talk and plan. Make it special and romantic. Some like to have a glass of wine and maybe a massage to relax you and set the mood.

    Don’t hurry into it. Intimacy has to do with all the tenderness and affection you share. If you are ready mentally and emotionally, it will help your body respond physically the way it was designed to do. There should be no pressure.

    Fitness and Health and Intimacy

    Having a hysterectomy can weaken pelvic muscles. There are great benefits in working to strengthen them.

    Women with bladder control problems may find reduced leakage with the strengthening of pelvic muscles. HysterSisters also report heightened sexual enjoyment with the toning of these muscles.

    Check with your doctor or nurse to teach you the correct technique. You can also check yourself by placing a finger in your vagina and squeezing around it (After your doctor releases you at your surgical post-op appointment. Until then, nothing in the vagina.). When you feel pressure around your finger, you are using the correct muscles.

    Try to keep everything relaxed except the muscles right around the vagina. At the same time, do not bear down or squeeze your thigh, back or abdominal muscles. Breathe slowly and deeply. At first you can do the exercises with your knees together (lying or sitting).

    We recommend doing the exercises for five minutes twice a day. You should squeeze the muscles for a count of four and relax for a count of four. With practice it will become easier as the muscles get stronger.

    The great thing about Kegel exercises is that they are easy to do anywhere. Many women create a routine of doing Kegel exercises for 5 minutes before they get up in the morning and for 5 minutes before going to sleep.

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