Effects of Hysterectomy on Sexual Function

Lonnée-Hoffmann, Risa; Pinas, Ingrid

doi:10.1007/s11930-014-0029-3

Cited by 71 publications

(62 citation statements)

References 66 publications

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“…Prospective studies often report that sexual functioning improves for most women following hysterectomy for benign indications. 24,25,26 However, these studies typically compare pre-surgery sexual function, assessed within a few weeks prior to surgery, to subsequent symptom relief and may not consider the impact of a bilateral oophorectomy in conjunction with a hysterectomy, factors that may overstate benefits of hysterectomy. Research has not been conducted in longitudinal cohorts of women with extensive measurement of sexual function and relevant covariates well before and post-surgery to determine whether hysterectomy has an impact on sexual function separate from that of aging.…”

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confidence: 99%

Change in sexual functioning over the menopausal transition: results from the Study of Women's Health Across the Nation

et al. 2017

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Objective To identify whether there is a decline in sexual functioning related to the menopause transition or to hysterectomy. Methods In a cohort of 1,390 women aged 42–52, with intact uterus and at least one ovary, not using hormone therapy, and pre- or early perimenopausal at baseline, we fit piecewise linear growth curves to 5,798 repeated measurements (7 visits spanning 14.5 years) of a sexual functioning score (range, 5–25) as a function of time relative to date of final menstrual period (FMP) or hysterectomy. Results Mean sexual functioning at baseline in women with a dateable FMP was 18.0 (standard deviation, 3.4). There was no change in sexual function until 20 months before the FMP. From 20 months before until one year after the FMP, sexual function decreased by 0.35 annually (95% CI:−0.44, −0.26) and continued to decline more than one year after the FMP, but at a slower rate (−0.13 annually, 95% CI:−0.17, −0.10). The decline was smaller in African-Americans and larger in Japanese compared to whites. Vaginal dryness, lubricant use, depressive symptoms, or anxiety did not explain decline in sexual function. Women who had a hysterectomy prior to the FMP did not show decline in sexual function prior to hysterectomy, but scores declined afterwards (0.21 annually, 95% CI:−0.28, −0.14). Conclusions Decline in sexual function became apparent 20 months prior to FMP and slowed one year after FMP through 5 years afterwards. A decline in sexual function was observed immediately after hysterectomy and persisted for the 5 years of observation.

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confidence: 99%

Change in sexual functioning over the menopausal transition: results from the Study of Women's Health Across the Nation

et al. 2017

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“…El que, tras la histerectomía, encontremos mejoría en la mayoría de los dominios y ningún cambio en el resto, es acorde con gran parte de la bibliografía consultada 14,59,69,70,71,72 . Según Helström, la eliminación de los síntomas es la principal causa de la mejoría en la función sexual 73 .…”

Section: Discussionunclassified

“…haya realizado ooforectomía bilateral añadida a la histerectomía puesto que esto sí que está claro que se asocia con peor función sexual 59 .…”

Section: Discussionunclassified

“…Ahora bien, también se observa que entre un 10-20% de mujeres empeoran su función sexual, esto ocurre sobre todo si antes existen problemas sexuales o depresión, también se observa que se empeora con más probabilidad si la indicación de la histerectomía es endometriosis. Si la histerectomía lleva añadida ooforectomía bilateral sí que se encuentra empeoramiento de la función sexual de forma significativa 59 .…”

Section: Histerectomía Y Función Sexualunclassified

“…Lo que dejan claro multitud de estudios es que la información y la educación por parte del personal sanitario sobre los potenciales resultados adversos en la sexualidad de la mujer tras la histerectomía, aumentan la satisfacción con los resultados del procedimiento y mitiga la ansiedad preoperatoria 9,59 .…”

Section: Histerectomía Y Función Sexualunclassified

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Función Sexual Tras 9 Meses De Una Histerectomía : Comparación De Los Resultados Del Cuestionario De Salud Sexual Fsm® Versus Percepción Subjetiva De La Mujer

Parra¹,

Merlo²,

Mirasol³

et al. 2017

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Uterine Cancer After Risk-Reducing Salpingo-oophorectomy Without Hysterectomy in Women With BRCA Mutations

et al. 2016

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Importance The link between BRCA mutations and uterine cancer is unclear. Therefore, although risk-reducing salpingo-oophorectomy (RRSO) is standard treatment among women with BRCA mutations (BRCA+ women), the role of concomitant hysterectomy is controversial. Objective To determine the risk for uterine cancer and distribution of specific histologic subtypes in BRCA+ women after RRSO without hysterectomy. Design, Setting, and Participants This multicenter prospective cohort study included 1083 women with a deleterious BRCA1 or BRCA2 mutation identified from January 1, 1995, to December 31, 2011, at 9 academic medical centers in the United States and the United Kingdom who underwent RRSO without a prior or concomitant hysterectomy. Of these, 627 participants were BRCA1+; 453, BRCA2+; and 3, both. Participants were prospectively followed up for a median 5.1 (interquartile range [IQR], 3.0–8.4) years after ascertainment, BRCA testing, or RRSO (whichever occurred last). Follow up data available through October 14, 2014, were included in the analyses. Censoring occurred at uterine cancer diagnosis, hysterectomy, last follow-up, or death. New cancers were categorized by histologic subtype, and available tumors were analyzed for loss of the wild-type BRCA gene and/or protein expression. Main Outcomes and Measures Incidence of uterine corpus cancer in BRCA+ women who underwent RRSO without hysterectomy compared with rates expected from the Surveillance, Epidemiology, and End Results database. Results Among the 1083 women women who underwent RRSO without hysterectomy at a median age 45.6 (IQR: 40.9 – 52.5), 8 incident uterine cancers were observed (4.3 expected; observed to expected [O:E] ratio, 1.9; 95% CI, 0.8–3.7; P = .09). No increased risk for endometrioid endometrial carcinoma or sarcoma was found after stratifying by subtype. Five serous and/or serous-like (serous/serous-like) endometrial carcinomas were observed (4 BRCA1+ and 1 BRCA2+) 7.2 to 12.9 years after RRSO (BRCA1: 0.18 expected [O:E ratio, 22.2; 95% CI, 6.1–56.9; P < .001]; BRCA2: 0.16 expected [O:E ratio, 6.4; 95% CI, 0.2–35.5; P = .15]). Tumor analyses confirmed loss of the wild-type BRCA1 gene and/or protein expression in all 3 available serous/serous-like BRCA1+ tumors. Conclusions and Relevance Although the overall risk for uterine cancer after RRSO was not increased, the risk for serous/serous-like endometrial carcinoma was increased in BRCA1+ women. This risk should be considered when discussing the advantages and risks of hysterectomy at the time of RRSO in BRCA1+ women.

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Effects of Hysterectomy on Sexual Function

Cited by 71 publications

References 66 publications

Change in sexual functioning over the menopausal transition: results from the Study of Women's Health Across the Nation

Change in sexual functioning over the menopausal transition: results from the Study of Women's Health Across the Nation

Función Sexual Tras 9 Meses De Una Histerectomía : Comparación De Los Resultados Del Cuestionario De Salud Sexual Fsm® Versus Percepción Subjetiva De La Mujer

Uterine Cancer After Risk-Reducing Salpingo-oophorectomy Without Hysterectomy in Women With BRCA Mutations

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