Related Health Issues
According to a study published in 1999 on Sexual Dysfunction in the United States (JAMA 1999;281:537-544), as many as 43% of all women in the U.S. experience some form of sexual dysfunction. Before we can even begin to look at the issue of sexual dysfunction potentially occurring as the direct result of a pelvic surgical procedure, we must first recognize that there is quite clearly a problem in this nation with female sexual function that desperately demands attention. The information gathered for this particular study used a national probability sample of 1749 women and 1410 men aged 18 to 59 years.
While the results written about in this study didn't identify prior surgical procedures that any of the women may have possibly undergone, it was still an astounding collection of data filled with valuable nuggets of information. Some key points:
In reading this study, the sheer numbers of women in this country not enjoying a healthy sex life free of sexual dysfunction nearly blew my socks off. But wait, this isn't the only study that's been done; others have estimated that up to 76% of women have complaints of sexual dysfunction which include: decreased libido, vaginal dryness, pain with intercourse, decreased genital sensation and difficulty/inability to achieve orgasm. Perhaps half of all women over the age of 40 have sexual complaints. Yikes! That's a lot of women.
In reviewing the sexual dysfunction studies that have been done on women who've undergone hysterectomy, something startling pops to the surface. Study after study shows sexual dysfunction for women both pre and post-hysterectomy at lower levels than the national population samples. Due to the impact of disease that often brings on depression, abnormal bleeding, pain and sexual discomfort, one would think that the number of women reporting some element of sexual dysfunction prior to hysterectomy would be HIGHER than the general population studies. Instead, hysterectomy studies all show levels of dysfunction for these women both before and after their hysterectomy as being LOWER than the general population. Clearly, something is wrong with either the general population studies or the hysterectomy and sexual functioning research.
Looking over the data collection methodologies for both types of studies, time and again the collection methods and questions asked of women in the hysterectomy studies were limited in scope and did not recognize or inquire about the full range of sexual dysfunction that potentially exists in the female population. If only four questions regarding sexual function are asked of women undergoing hysterectomy (as with the study recently published in JAMA), are their answers really going to provide a comprehensive picture of these women both before and after hysterectomy? Without a baseline reading of what sexual function was like for these women prior to the onset of disease, is pre and post hysterectomy data comparison and analysis truly relevant?
The flaws that exist in the hysterectomy and sexual function studies are abundant. Oftentimes, the research is handled by physicians or academicians who are NOT experts in female sexual function and who do NOT use validated questionnaires or relevant response point systems for their questions. Data analysis is typically incomplete and inconclusive and, as a result, I have a terrible time trying to understand the doctors who tell patients, "research shows that a hysterectomy has a positive impact on sexual function." This answer is frequently served up as a reassuring and definitive response to the question: "How will my sex life be impacted by a hysterectomy -- will it cause sexual dysfunction?" From my viewpoint, the research that would truly answer that question has simply not even been approached yet.
What You'll Find
Jennifer Berman, MD
|Network for Excellence in Women's Sexual Health (NewShe). Resources for women dealing with sexual function problems such as lack of desire, arousal, lubrication, orgasm, and pain. Includes an interesting and insightful discussion of the potential role for nerve-sparing hysterectomy.|
|Oxygen.com||All About Women. A Self Guided Sexual Anatomy Tour.|
Unfortunately, JAMA has gone the route of online PAID subscriptions. This paper and the next 2 links in this table to papers are no longer available in full text to the average netizen. The links provided here will take you to the abstracts. These papers are worth reading in full detail. Please check with your librarian to obtain copies or purchase them in full using an online service.
|Edward O. Laumann, PhD; Anthony Paik, MA; Raymond C. Rosen, PhD||Sexual Dysfunction in the United States. JAMA Vol. 281 No. 6, February 10, 1999.|
Erick Janssen, PhD
The Kinsey Institute
|Sexual Function After Hysterectomy. Letter to the Editor. JAMA Vol. 283 No. 17, May 3, 2000.|
|Julia C. Rhodes, MS; Kristen H. Kjerulff, PhD; Patricia W. Langenberg, PhD; Gay M. Guzinski, MD||Hysterectomy and Sexual Functioning. JAMA; Vol. 282 No. 20, November 24, 1999|
|www.hisandherhealth.com/||hisandherhealth.com||Medical/Sexual Health Views Before They're News. The latest information for both men and women on the topic of sexual health brought to you by the leading researchers in the nation. The most comprehensive site available on the internet covering female sexual dysfunction.|
Go Ask Alice!
Columbia University's Health Education Program
|Online archives of questions asked/ answered about sex. Got a question yourself? Go Ask Alice! (As an "over the age of 40" kind of person, I learned a few new things by visiting this site. *::::BLUSH::::* There are college-age men and women out there with more questions than I ever had when I was 20!)|
|www.sexualhealth.com/||Sexual Health Network||Comprehensive website of sexual function. Tremendous amount of information on female sexual dysfunction and supporting articles.|
|The Truth About Women. A new anatomical study shows there is more to the clitoris than anyone ever thought.|
|www.aasect.org/||American Association of Sex Educators, Counselors and Therapists (AASECT)||
Not-for-profit, interdisciplinary professional organization consisting of sexuality educators, sex counselors, sex therapists, etc. who share an interest in promoting understanding of human sexuality and healthy sexual behavior.
"Find a therapist" doctor locator.
This link goes to the C-SPAN instructional page for ordering archived copies of tapes.
November 12, 1999
Dr. Myron Murdock
Director, The Impotence Institute of America
Sexual Dysfunction in Women (Video of National Press Club speech)
This speech is only available now through purchase of archival tape. Information on the C-SPAN site provides more information on how to purchase a copy of this presentation. ($7 plus $5.50 s&h)
on Female Sexual Dysfunction
Can having a hysterectomy impact a woman’s sexual function? What about going through menopause? Dr. Jennifer Berman and Dr. Laura Berman answer the questions frequently asked.
Louanne Cole Weston, Ph.D., board-certified sex therapist
|9/17/98 Hysterectomy Can Have an Impact on Sexuality|
|www.msnbc.com/news/411017.asp||MSNBC||Viagra fails in study of women. No benefit in younger females.|
|www.msnbc.com/news/402151.asp||MSNBC||Viagra may help some women. Research shows better orgasms, increased satisfaction.|
|Boston University School of Medicine||New Perspectives in the Management of Female Sexual Dysfunction -- Excellent info from the 1998 conference held in Boston. Interesting links including one from Dr. Jennifer Berman's name that is an online chat transcript from ABCNews that she did in 1998.|
|Is there sex after hysterectomy?|
|Sex, Drugs and Lack of Funding Would you take a sex-enhancing drug as soon as it came out?|
Dr. Tori Hudson
|low sex drive|
Roy Stains with Toby Hanlon
|SPECIAL REPORT: Can Your Sex Life Be Saved?|
The Hysterectomy Association (UK)
|How hysterectomy affects women.|
|Pfizer||Patient summary of information on Viagra.|
|Pfizer||"Professional" informational insert for Viagra. Read info at this link for complete details on Viagra. I have a question for Pfizer though: Why do you make your users click the "I am a healthcare professional" link prior to allowing access to this page? This product insert is available from any pharmacist and should be available to all patients who receive this drug. (BTW, I can direct this question to you folks from within this webpage because I know full well when you visit my website. How about sending me some email and answering this question?)|
|6/21/98 Women and Sex: On This Topic, Science Blushes|
America's leading Sex Therapist online.
Also, decorate your desktop with Dr. Ruth's very own special "goodies." Need a Kama Sutra background? How about a sperm cursor? How about folder icons for your computer that look like a cervix? (and lots of other body parts!) or, how about new sound files for your computer actions.....like "it's safe to try clicking...even without contraception!" In the midst of sexual dysfunction, I've got to hand it to Dr. Ruth for bringing a smile to my face. :)
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This page last updated Saturday, February 02, 2002