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

JAMA. 1999;282:1934-1941.

Context  Women considering hysterectomy often are concerned about its potential effects on their sexual functioning but the effects of hysterectomy on sexual functioning remain unclear.

Objective  To examine changes in sexual functioning after hysterectomy.

Design and Setting  A 2-year prospective study (Maryland Women's Health Study) of hysterectomy, which included measures of sexual functioning prior to hysterectomy and at 6, 12, 18, and 24 months after hysterectomy, performed during 1992 and 1993.

Patients  Of 1299 women interviewed prior to hysterectomy, 1101 (84.8%) completed the study and provided information about their sexual functioning. Most were between the ages of 35 and 49 years, white, married or living with a partner, and high school graduates.

Main Outcome Measures  Frequency of sexual relations, dyspareunia, orgasm, vaginal dryness, and sexual desire.

Results  The percentage of women who engaged in sexual relations increased significantly from 70.5% before hysterectomy to 77.6% and 76.7% at 12 and 24 months after hysterectomy. The rate of frequent dyspareunia dropped significantly from 18.6% before hysterectomy to 4.3% and 3.6% at 12 and 24 months after hysterectomy. The rates of not experiencing orgasms dropped significantly from 7.6% before hysterectomy to 5.2% and 4.9% at 12 and 24 months after hysterectomy. Low libido rates also decreased significantly from 10.4% before hysterectomy to 6.3% and 6.2% at 12 and 24 months after hysterectomy. The distribution of women not reporting vaginal dryness in the past month improved significantly from 37.3% before hysterectomy to 46.8% and 46.7% at 12 and 24 months after hysterectomy. Prehysterectomy depression was associated with experiencing dyspareunia, vaginal dryness, low libido, and not experiencing orgasms after hysterectomy.

Conclusions  Sexual functioning improved overall after hysterectomy. The frequency of sexual activity increased and problems with sexual functioning decreased.

Author Affiliations: Departments of Epidemiology and Preventive Medicine (Ms Rhodes and Drs Kjerulff and Langenberg) and Obstetrics and Gynecology (Dr Guzinski), School of Medicine, University of Maryland at Baltimore, Baltimore. Dr Guzinski is now with the Department of Obstetrics and Gynecology, St Joseph's Medical Center, Towson, Md.

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