Hysterectomy often improves sex life.

Many women facing the prospect of hysterectomy, or removal of the uterus, fear a loss of sexual function. Studies have presented mixed findings on the issue, adding to the anxiety.

Now, a study of 1,101 women who had hysterectomies finds that afterward they generally wanted and had sex more often, were more likely to reach orgasm, experienced less vaginal dryness, and were less likely to have pain during sex than was the case before surgery.

Researchers identified women, average age 43, who had undergone hysterectomy at 28 randomly selected Maryland hospitals. The researchers questioned the women shortly before the hysterectomy and again 6, 12, 18, and 24 months afterward.

The proportion of women having had sex within a month before being interviewed rose from 71 percent before surgery to 78 percent 1 year after it, the scientists report in the Nov. 24, 1999 JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION. Among those having had sex, the number reporting pain during sex dropped from 19 percent to 4 percent after a year, while the number who didn't reach orgasm fell from 8 to 5 percent during that time. Women reporting vaginal dryness fell from 63 percent to 53 percent a year after surgery. The percentages stayed roughly the same over the next year.

Because the women were interviewed shortly before undergoing surgery--when physical discomfort or anxiety about the operation might have inhibited sexual activity--the study may overestimate the improvement in sexual function brought on by the surgery, says coauthor Kristen H. Kjerulff, an epidemiologist at the University of Maryland at Baltimore.

On the other hand, these women didn't have life-threatening illnesses. They underwent hysterectomies because of benign growths in the uterus and other noncancer conditions. Most had already tried a variety of treatments, such as medication, for up to 2 years.

"This wasn't like a fly-by-night decision for most of these women," says Kjerulff. Afterward, they felt better in general, and this may have enhanced libido, Kjerulff says.