Only 22 percent of the women who had hysterectomies, compared to 34 percent of the non-hysterectomy women, reported a sexual problem. Those women in the hysterectomy group reported more sexual satisfaction! For example, in one study, 97 women who had experienced hysterectomy were compared with 249 women of a similar age who had not had surgery. Looking more specifically at a couple of studies that evaluated the effects of hysterectomy on sexual activity, one finds the results quite variable. Some women who are at risk for adverse psychosexual problems certainly benefit from extra couseling before surgery. To minimize some of these postoperative problems, it's important for the patient to ask questions about effects of the surgery, as well as for the surgeon to assess the patient's psychological concerns and fears and potential effects on sexual response during the preoperative discussions. Women with post-op problems sometimes are poorly educated and have little understanding of the post-surgery hormonal change or what to expect afterwards.

Those women who do develop problems are frequently those with simultaneous bilateral oophorectomy and resultant decreased estrogen secretion, as well as those who have preoperative sexual conflicts, or those who believe that a hysterectomy diminishes one's femininity. Some women may experience adverse psychological sequelae to hysterectomy, but most do not experience psychosexual problems postoperatively. When the hysterectomy procedure results in relief for the patient from symptoms such as chronic pain, excessive uterine bleeding or endometriosis, the patient usually has an improvement in quality of life measures and this impacts sexual function in a positive way. Fortunately, most hysterectomies are performed for noncancerous, benign disorders (approximately 90 percent of the time). For example, cancer surgery in younger women, who might otherwise have expected to have children, is likely to be more generally and sexually disruptive than surgery for benign disorders.