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Hysterectomy and Sexual Dysfunction
ABC Good Morning America


On November 23, 1999, Good Morning America presented a story with numerous interviews on the topic of hysterectomy and female sexual dysfunction. It was part of their month long series on Sex and the Healthy Woman and this particular episode just happened to coincide with the release of a study on sexual functioning and hysterectomy. The following is a rough transcript of what was aired that morning.

Beth Tiner, founder of Sans Uteri, along with Elizabeth Plourde, author of The Ultimate Rape, were both interviewed for this ABC Good Morning America special.


Diane Sawyer
(I missed the opening sentence here. I believe she basically said that there is a new study out today -- but gave no additional details regarding that study.)

But it doesn't seem to be the perception of a lot of women who've had them. In our series, Sex and the Healthy Woman, we've been trying to answer questions that women have and raise some new ones and today Dr. Nancy Snyderman takes a look at a growing controversy. The effect of hysterectomy on sex.
After C-sections hysterectomy is the most common operation performed on women in the U.S. and yet doctors don't even know whether they could be affecting a woman's sexual function forever.


Elizabeth Plourde
It's a devastating experience. And it's even more devastating when there's absolutely no preparing.
Nancy Snyderman
Elizabeth Plourde describes the havoc she believes that hysterectomy has wreaked on her sex life.
Elizabeth Plourde
It never occurred to me that I would be losing my ability to respond sexually afterwards.
Nancy Snyderman
And she's not alone. Beth Tiner says that after her hysterectomy her sex life also took a turn for the worse.
Beth Tiner
Orgasms used to be a great big wave. A great crash. And I'd -- 'oh, just don't touch me for a minute, just let me be' -- and it was wonderful. And now it's I think well, humm, I wonder if that was, maybe that was an orgasm.
Nancy Snyderman
Dr. Lee Learman is a specialist in gynecology now doing a study looking into sex after hysterectomy. He says that if men had loss of sexual function after a procedure the research would be a priority. Not so with women.
Dr. Lee Learman, UCSF
The state of the evidence is quite poor at this point. We can't really tell our patients what to expect for sexual functioning after a hysterectomy.
Nancy Snyderman

Yet a new study, due out today, claims that women's sex lives actually improve after hysterectomy. Dr. Yvonne Thornton represents the American College of Obstetricians and Gynecologists.

Hysterectomy and Sexual Functioning

Julia C. Rhodes, MS; Kristen H. Kjerulff, PhD; Patricia W. Langenberg, PhD; Gay M. Guzinski, MD,

JAMA; Vol. 282 No. 20, November 24, 1999

Dr. Yvonne Thornton
I would dare to say that the vast majority of women do not have sexual dysfunction following hysterectomy.
Nancy Snyderman
Hysterectomy has been performed since the 1800's and is the most common surgery done on women in the United States. But believe it or not, until recently, no one has asked how it could be affecting women's sex lives. It could be because doctors don't know the basics of female sexuality.
Nancy Snyderman
What causes an orgasm?
Dr. Yvonne Thornton
What causes an orgasm, I wish I could answer that question. I -- the big O, have no idea. I wish I was a sex therapist and I probably could tell you. But as a gynecologist, I wasn't taught that in medical school.
Nancy Snyderman
Aren't people being taught it now in medical school?
Dr. Yvonne Thornton
I don't think so, no. No.
Nancy Snyderman
Since doctors don't know how it works, they can't know if they're literally taking a slice out of your sex life. There are nerves and blood vessels that come into the uterus at a very low position, near where the cervix and uterus meet. These nerve fibers are microscopic, not visible with the naked eye. They travel around and through the cervix and end up in places that may affect sexual function. During a hysterectomy, incisions are made very close to this area in order to take out the uterus and sometimes the cervix. Dr. Jeanette Brown is a gynecologic surgeon who says she's rocking the boat, telling other gynecologists what they don't want to hear.
Dr. Jeanette Brown, UCSF Standard Healthcare
At the time of a hysterectomy, we are clamping and cutting nerves. In surgery, rarely can we see nerves and we clearly cannot see nerves at the time of hysterectomy. So if we are causing nerve damage, we really don't know that. And there's certainly a potential that we could be causing nerve damage that affects sexual function.
Nancy Snyderman
And this could be one reason that women like Beth experience a lackluster sex life post hysterectomy and no promises that it will ever get back to the way it was.
Beth Tiner
It is devastating at times to realize that I'm looking at -- if I live to be my grandmother's age, I'm looking at 60 years of markedly less than stellar sexual response. ..... 60 years.
Nancy Snyderman
And as for Elizabeth Plourde, that kind of future brings with it some strong emotions.
Elizabeth Plourde
There are times when I realize that I am no longer the same person and it's those times that are sad. Very sad. And I don't think that sadness can ever go away.
Diane Sawyer
Dr. Nancy Snyderman joins us now. So. Nancy, we heard what these women had to say. We now have the study which seems to say that most women have increased or enhanced sexual function. What is the truth?
Nancy Snyderman
The truth is somewhere in between. The truth is the fact that the medical literature doesn't always agree. Past studies have said yes, there seems to be some problem with women's sexual response afterwards. Is it arousal? Is it a desire? Is it orgasm? The new study says that in fact there's a sexual liberation. Women feel better. There are fewer complaints. I think the bottom line is that you have to weigh the pros and cons and look at why you are being suggested at surgery. Do you have cancer? Is it benign disease? Are there alternatives? And then, also, look for help to therapists who can help tie in the mental well-being along with the absolute anatomical changes.
Diane Sawyer
And is there anything you would say to a surgeon before going in?
Nancy Snyderman
I would ask a lot of questions, including the alternatives, and ask, also, whether the cervix must be taken away with the rest of the uterus. There's some pretty good evidence that shortening just the vaginal wall itself and perhaps leaving it longer, leaving the cervix might help a lot of women. Ask those hard questions and get a second opinion.
Email Good Morning America
Email Good Morning America about this story. Ami Schmitz was the Sex and the Healthy Woman series producer.
Email Julia C. Rhodes
Email the author, Julia C. Rhodes, of the Hysterectomy and Sexual Functioning study.
Email ACOG
Email the American College of Obstetrics and Gynecology (ACOG) about this story. Dr. Yvonne Thornton was the ACOG representative who was interviewed.

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