Sexual Functioning Following Elective Hysterectomy: The Role of Surgical and Psychosocial Variables

Abstract

In this article, two studies were conducted to investigate the surgical and psychosocial correlates of women's post-hysterectomy sexual functioning. In Study 1, sexual functioning was measured in an online convenience sample of 65 women who had undergone elective hysterectomy. Results suggested that most women experienced improved sexual functioning after their hysterectomy. Women who underwent hysterectomy to treat endometriosis reported less improvement in sexual functioning as compared to women who had hysterectomies for other indications, and women who had abdominal hysterectomies reported less improvement in sexual functioning as compared to women who had vaginal hysterectomies. Sexual functioning post-hysterectomy was associated with psychosocial variables, particularly body esteem and relationship quality. In Study 2, sexual functioning was investigated at two time points three to five months apart in a sample of 14 women who reported developing sexual problems following their elective hysterectomies. Results suggested that, among women suffering from post-hysterectomy sexual dysfunction, sexual pain and difficulty with orgasm increased over time.

This study was funded by the Athena Institute for Women's Wellness and was completed as part of a Postdoctoral Fellowship from The Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University, awarded to Zoë D. Peterson. We thank Laura Middleton for her help designing the study and Sarah Muterko and Jenna Potts for their help with recruitment.

Notes

Note. The analysis of variance (ANOVA) for the Change in Sexuality Scale and the multivariate analysis of variance for the Female Sexual Function Index (FSFI) subscales were both significant. The table depicts results of post-hoc univariate ANOVAs.

^a n = 23.

^b n = 42.

^c Low numbers indicate improved sexual functioning post-hysterectomy; high numbers indicate diminished sexual functioning post-hysterectomy.

^d Higher scores indicate better sexual functioning or greater satisfaction.

Note. Table depicts results of univariate analyses of variance. For Female Sexual Function Index (FSFI) subscales, the multivariate analysis of variance was not significant.

^a n = 44.

^b n = 21.

^c Low numbers indicate improved sexual functioning post-hysterectomy; high numbers indicate diminished sexual functioning post-hysterectomy.

^d Higher scores indicate better sexual functioning or greater satisfaction.

Note. Table depicts results of univariate analyses of variance. For the Female Sexual Function Index (FSFI) subscales, the multivariate analysis of variance was not significant. BSO = bilateral salpingo-oopherectomy; HRT = hormone replacement therapy; CSS = Change in Sexuality Scale.

^a n = 12.

^b n = 11.

^c n = 42.

^d Low numbers indicate improved sexual functioning post-hysterectomy; high numbers indicate diminished sexual functioning post-hysterectomy.

^e Higher scores indicate better sexual functioning or greater satisfaction.

Note. CSS = Change in Sexuality Scale; FSFI = Female Sexual Function Index; BES = Body Esteem Scale; DAS = Dyadic Adjustment Scale; DASS = Depression, Anxiety, and Stress Scale.

^a Low numbers indicate improved sexual functioning post-hysterectomy; high numbers indicate diminished sexual functioning post-hysterectomy.

^b Higher scores indicate better sexual functioning or greater satisfaction.

*p < .05. **p < .01. ***p < .001.

Note. Post-hysterectomy sexual function was measured with the Female Sexual Function Index total score, with higher scores indicating better sexual functioning. BES = Body Esteem Scale; DASS = Depression, Anxiety, and Stress Scale; DAS = Dyadic Adjustment Scale.

Note. N = 14. Higher scores on the Female Sexual Function Index (FSFI) indicate better sexual functioning or greater sexual satisfaction.

Note. FSFI = Female Sexual Function Index; BES = Body Esteem Scale; DAS = Dyadic Adjustment Scale; BDI–II = Beck Depression Inventory–Second Edition; BAI = Beck Anxiety Inventory.

^a Higher scores indicate better sexual functioning or greater satisfaction.

*p < .05. **p < .01. ***p < .001.