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Unread 03-12-2004, 12:42 PM
sex after hysterectomy

OK Sisters,

I have a sensitive question to ask you. Ever since I've had my hysterectomy in Aug. the sex hasn't been to great in fact it's been down right uncomfortable. Of course it was along time after the hysterectomy because I had Chemo right afterwards. We used the uusual KY but that hasn't helped and I just don't get in the mood and that's not like me at all. I would appreciate any advice.

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Unread 03-12-2004, 05:31 PM
sex after hysterectomy

s Bonnie

Your question is a good one. And one that we have discussed on Cancer Concerns from time to time. But it has been awhile now.

I read Liz Tilberis's book: No Time to Die. Liz was diagnosed with ovarian cancer. I am not recommending the book, by the way. Her gyn onc did tell her that the diagnosis of cancer combined with a radical TAH is like a sexual holocaust.
When I read this, I found it to be an apt description.

I had my surgery at age 49 and was still premenopausal.
HRT is not something I wish to use nor does my gyn/onc advise it.

For me sex now requires much more mental and physical preparation. Including more foreplay etc. Once I am ready to go, my body parts work as well as ever, and just as strongly as ever.
It's just a matter of giving myself enough time to get in the mood.
And once I am in the mood, I wondered why I waited so long since the last time.
Sometimes I am perfectly content to just make my hubby happy.

KY is the pits. But I understand now they have a newer version that heats up. I used replens for a time. But now I find my natural lubrication is working very well again.

Best wishes. I hope more sisters add to the discussion.

Unread 03-12-2004, 11:30 PM
sex after hysterectomy

KY can be quite drying. We have liked Sylk and Astroglide .

What often happens after a long time is that the vagina can atrophy and begin to actually close up, especially with all the "extra" influences of chemo, etc. Some women have found that stretching with vaginal dilators can help (using LOTS of lube). You may also want to ask your doctor about some low-dose compounded testosterone cream or vaginal estrogen cream. It may only take a tiny amount (I know that (((Dorrie))) has said that she uses a "dab" with an ovarian CA diagnosis) to help bring elasticity back to the tissues; even a month for healing and "practice", and then perhaps that's all you'd need.

The libido thing is problematic for many of us, and it's hard to explain to our partners. I did find testosterone to be a big help; once your ovaries are gone, you lose ALL sources of testosterone. I use a very low concentration of compounded, and not even every day, but it does help a lot.

It's worth a very frank discussion with your oncologist. I know all too many doctors accept the "sexual holocaust" as an inevitability -- but as (((Karenann's))) experience shows, it doesn't have to be. It takes, however, time, patience, the right lubricant (both mental and physical ) and perhaps the right touch of chemical help.

Medications, such as certain anti-depressants and blood pressure medications, can also really suppress libido and ability for orgasms. Other medications can have real drying effects (antihistamines are notorious for this). This whole libido thing requires a real balancing act, maximizing every thing that you can and adding in a good measure of patience.

Ask also about the dilators; if you do a search around here, others have used them. (((Jeanine))) has written about her experience with them in a number of posts. The thing is, if it's been a period of months, you may not be "open" enough to be successful without the exercise that the dilators can give you.

Take care. I hope you find some relief, and a return to a healthy sex life soon!

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Unread 03-13-2004, 01:06 AM
sex after hysterectomy

(((((Bonnie))))) I'm so sorry you're having trouble with discomfort during sex. You've already gotten some great replies; I just wanted to add that there are a couple of articles over in the GYN Cancer Resources section of our Resource Links Directory that you might want to take a look at because they have some good suggestions about how to deal with this issue:

I'm assuming you are not able to use HRT... if that's the case, you still might also benefit from taking a look at a few of the threads on sex after hysterectomy over in the No-Hormone Desert Oasis forum:

I'm glad you asked the question... I'm sure there are plenty of other ladies who will also benefit from your having asked it. I hope some of this helps!
Unread 03-13-2004, 06:50 AM
sex after hysterectomy

Bonnie -

I was in my 40s and no where near menopausal when I had my hyst - I had only stopped nursing my toddler a few months earlier.

I did use oral estrogen for a while after my hyst, but stopped after a long discussion with my doc after the results of several clinical trials came in. There is much controvery over using estrogen after an ovarian or breast cancer dx.

I still use vaginal estrogen. 1gm of premarin cream 2x a week is plenty (after using it every day for a week). Although I would otherwise prefer bio-identical hormones, I have found premarin to be best for this purpose - for me, it gives the same effect with much less cream/estrogen

I found it was close to a year after my hyst before I felt sexually anything close to normal - the physical and hormonal changes are dramatic. Chemotherapy and just the reality of a cancer diagnosis do not exactly improve one's sexual response.

I used a midwife with one of my births and she said about birth - which is much less traumatic than a cancer hyst, something like - "you know this nonsense about being sexually ready at 6 months is just crap. what docs mean is that sex will do you no harm at 6 weeks. Everyone heals emotionally at their own pace. Some will be ready at 6 weeks, others at 6 months, and others at a year."

I hate lubricants. I found that using the long-lasting kind like replens and ky long lasting, which had an effect when used not "during" sex worked better for me. So I usually use one of those once a week or so, especially if I forget to use the estrogen cream.

Unread 03-14-2004, 06:59 PM
sex after hysterectomy

Thanks so much Sister's for your advice. I didn't even think about the dialators. I Have felt very unfeminine :cry:since my surgery, especially with no hair due to the Chemo. I also failed to mention I'm also on Effexor. I will talk with my Dr. and let you know how things are going. It really encourages me with all your help.

Unread 03-15-2004, 02:58 PM
dialator question

I had a radical hyst in February/04 and will start simultaneous chemo and radiation in April /04 -- they warned me about the shrinking of the vagina and talked about a dialator to help later on but I was too overwhelmed and embarassed to ask what that was!

Can anyone tell me about their experience with this?
Unread 03-17-2004, 10:59 AM
sex after hysterectomy

Ok Sisters ,I made a appointment to see my Gyn/Onc but I'm not sure exactly what questions to ask, I don't want to leave the office without getting every bit of information. All advice will greatly help. My appointment is March 24. Because of this I have been very depressed.

Unread 03-19-2004, 08:57 PM
sex after hysterectomy

Hi (((Bonnie))), good for you for making the appointment and wanting to do your homework before you talk with the DR.

The first thing you need to find out is, can you use any form of hormonal treatment, whether it be systemic or vaginal? Most ladies with a cancer history or concerns are not on systemic HRT, but many can still use vaginal HRT's in small doses, because they don't appreciably penetrate to the other tissues in the body.

There are two hormones involved in sexuality on a simple level, estrogen and testosterone. Estrogen maintains the healthy, elastic, moist nature of the vaginal walls and allows them to lubricate, etc. as a response to sexual stimulation. Testosterone is responsible for libido (desire).

If your DR is one who says absolutely positively no hormonal treatments, there are still other alternatives you might be able to try. One that is showing tons of promise is Tibolone, aka Livial. Tibolone has been available in the UK and Europe for several years but is stuck in the FDA approval process in the US. It's a non hormonal medication which acts like hormones in some ways but not in others.. here is a link to a really interesting presentation about what it is and how it works, and all about sexuality after menopause:

I hope this helps in your discussion with your DR. Let us know how it goes, OK? I'm keeping my fingers crossed for you!

Unread 03-22-2004, 06:26 PM
sex after hysterectomy


Thanks for the info. I go for my appointment this Wed. so now I will have more information to be supplied with. Also the other night I had some spotting afterwards ,which was alittle upsetting. I just wish I would have been better informed before my hystertectomy!


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