anonymous on August 29, 2011

What can I do about vaginal dryness after a hysterectomy?

Ever since I had a complete hysterectomy (including ovaries), I’ve had trouble with vaginal dryness and loss of sexual pleasure or sensation. What can I do about my vaginal dryness?

answered by Annette Fuglsang Owens, MD, PhD on August 29, 2011

I appreciate your question, and I’ll do my best to provide you some useful information.

First, you’re not alone. Many women suffer from vaginal dryness after a hysterectomy, or even after menopause. Why? As you know, a total hysterectomy is a surgery that removes the uterus, and – as in your case – ovaries are removed during the same procedure for various health reasons. When the ovaries are removed, women usually experience menopause if they aren’t already menopausal. Ovaries provide many hormones to the body and their sudden removal through surgery results in rapid menopause.

That said, I would encourage you to discuss your symptoms with your gynecologist, who may prescribe hormone supplements for you. Specifically, given that you have vaginal dryness, it sounds like you may have anestrogen deficiency. And your decreased genital sensation could be a symptom of a testosterone deficiency.

One step you may want to take is to talk with your gynecologist about testing your hormone levels. Luckily, if you do have abnormal levels of hormones, there are a number of treatment options available, including a higher dose of your current medication or a different hormone replacement therapy. For instance, some creams are available that include both estrogen and testosterone and are applied directly to the vulva.

Your doctor may also be able to help you with other lubrication options. For example, there are vaginal moisturizers that might work for you. Additionally, vaginal lubricants may make your lovemaking more enjoyable, especially vaginal penetration. You and your partner can apply a water-based lubricant to your vagina. Keep the bottle handy nearby since the water part dries up and lubricant needs to be reapplied frequently. Both vaginal moisturizers and lubricants can be bought in most pharmacies and even in many regular grocery stores.

Also, have you heard of Kegel exercises? These are simple exercises that you can practice daily to strengthen the muscles of the pelvic floor. Simply flex the muscles you use to stop urine...these pelvic floor muscles are attached to the muscles around the vagina and the muscles between your vagina and anus (perineum).

Hold these muscles for 10 seconds then release and repeat 10 times. You can do this several times daily (in the morning, afternoon and evening) to strengthen these muscles. Many women report that voluntarily tensing the vaginal and perineal muscles just prior to a sensation of climax helps initiate orgasm.

There are even devices available that help you strengthen your pelvic floor muscles against a resistance. It’s an even more efficient way to strengthen muscles, just as working out with weights strengthens your muscles more than without weights.

Finally, don’t rush lovemaking. Be sure to communicate to your partner how much time you need, as well as the psychological and physical stimulation you require, to reach your fullest level of arousal.

I wish you good luck as you reclaim your comfort and pleasure in sex after your total hysterectomy.

Related info:

Annette Fuglsang Owens, MD, PhD

Dr. Owens is an AASECT-certified sexuality counselor. Her areas of expertise include the medical aspects of human sexuality and sexual problems, as well as the impact of STDs ⎼ and other diseases, illnesses and disabilities ⎼ on sexuality. Dr. Owens was educated at the University of Copenhagen in Denmark.

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