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Planning Retirement Online



Relationships - December 2013

It could be you ....


Maggi Stamp, LaterLife's Relationship Counsellor

Every month Maggi Stamp, a qualified and experienced relationship counsellor in private practice after 20yrs with Relate, writes about some of the emotional challenges we meet as we pass our half-way markers.  

For reasons of confidentiality Maggi never writes about a particular person's problems unless you have sent one in to be answered, but all her examples are based on problems raised by clients, family and friends over the years.

You can write to Maggi at for her to respond in the column.

When sex is not happening after a hysterectomy

I am 51 years old and earlier this year I had a full hysterectomy due to having fibroids in the wall of the uterus. I had tried various alternative treatments to avoid the operation but in the end my GP said I really shouldn't wait any longer to have the operation.
Although I have healed, and it is good to be without the draining symptoms I had for years, I still don't 'feel right'. It is hard to explain but I think I was rather surprised by how much I was knocked back by the operation and how long it took me to regain strength. My husband is trying to be understanding but can't understand why I am still nervous of having sex. I don't know either.
What do you think is going on?

This is definitely not the end of sexual activity and enjoyment for you.

But, it is important for you and your husband to appreciate that a hysterectomy is a major operation. Although routine work for a surgeon, it can be quietly life changing for women. Many of the changes are of course positive, but there also those which, if not considered carefully, can have a negative effect.

For very good reasons you have had your uterus (womb) removed. I am sure that physically your body will respond well and you are already glad to be free of the heavy periods, the pain, discomfort and total dragging tiredness which accompanies the presence of fibroids. But what you have lost is one of the organs exclusive you as a woman. All women are born with a womb, which at puberty becomes actively able to carry babies. It is not having babies which defines us as a woman, but the possibility of having a child. Indeed in women who do not bear children the uterus is not put to full use, but, being female, they will all go through the bodily preparation for the possibility of becoming pregnant, build up a uterine lining, ovulate , menstruate and so the cycle goes on, until menopause. You don't say if you have reached that point so forgive me if I assume you probably have, or are close to that stage. (Most women in the UK reach natural menopause around the age of 50-54).

The effects of hysterectomy that can be hidden from us are the more subtle physical signs and psychological ones. Menopause is, or can be, a disruptive time for a woman. The body is making major changes – again – and just as puberty upsets patterns in the teenager and pregnancy changes us temporarily, menopause affects many women with symptoms which, if they came singly, could be tricky but manageable. But as several of these tend to happen at once, the effect can be really hard to live with. Many of our women readers will be only too familiar with them either in retrospect or are living through them right now. I shan't write a list, but want to make the point that in the midst of this time, you have had a hysterectomy. Your hormones will not know where they are. The uterus is a key part of this process and now it has gone. In time all of this process will resolve and you will be back on an even keel, but for a year or so your body will be adjusting to the natural change and to the shock of medical intervention you have been through.

So much for the physical effects you are processing.  The psychological effects can be more complex. You feel better. Your symptoms have been relieved and that can be liberating. You look well and healthy. Your husband probably sees that as the main advantage. He'll be pleased you are no longer tired and in discomfort and will find it hard to appreciate that that doesn't always result in a rise in libido.  But the female libido is a tricky little thoroughbred! It takes time, tenderness, patience and a shelving of male ego to heal and support a partner through this loss.

The good news is that libido does not rely exclusively on the presence of the uterus. If the ovaries have been found to be healthy and remain in situ they will be working just as hard producing hormones which regulate sexual desire. Over a much longer period of time the ovaries will gradually produce less hormone and sexual desire might lessen as a result, but this is very gradual. In operations where the ovaries are also removed doctors are able to counter the sudden loss of hormone production by prescribing HRT (hormone replacement therapy) and this does a fine job for most women taking it.

But those hormones are what help us stay in touch with our sexual side. Without them, or with them in turmoil, which yours might be for a while, sexual desire is unlikely to be uppermost in your mind. We take some time to adjust emotionally. Our sleep patterns are affected, we have lost an important part of our body and, even though we do not rely on it to survive, we have lived with it and by the rhythm of it for all our adult lives, so we need some time to get used to finding a new balance in our bodies and our perception of ourselves. That organ is where, for many of us, babies have been carried and from where, with amazing power, they have been thrust forth into the world. Some women feel that really is what defined them and fear they have lost their identity for a while. Until powerful feelings such as that are thought about, talked about and worked through, we need extra understanding from a partner or spouse.

To try to have, or be persuaded to have, sex again too early might be painful until both external and internal scars have healed. Equally, having sex if you are not emotionally ready might lead to you being tense and your muscles will not relax enough for it to be comfortable. In general, the superficial physical scars will be healed after a few weeks. This obviously differs, woman to woman. The deeper scars will take 6 weeks or more but could remain a little sensitive for longer, and the emotional adjustments can be slower to ease, but can be hastened by a sympathetic partner who is willing to listen, accept it is not personal rejection or about something they have done, and happy to go at your pace.

You have control. When you feel ready, you can suggest a little caressing to begin with and gradually take things from there if that has been pleasurable. To continue to have sex after the menopause and after a hysterectomy is a good thing. It will not only help maintain your feeling of closeness with your partner, it will exercise muscles which if left unstimulated can become slack and atrophy. Remember you might need to use a lubricant to help with vaginal dryness. There are some excellent products freely available now in chemists and supermarkets. Your doctor might even prescribe one for you.

It is always worth reminding your husband that 'slow is the best' when it comes to sexual arousal and enjoyment. I am sure he'll take that message on board!


You can write to Maggi at for her to respond in the column.

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