As stressed earlier, androgens, the male hormones such as testosterone, have been found to result in a more direct effect on sexual desire, sexual arousal, and the overall sense of well-being. On the other hand, there's evidence that the loss of sexual desire caused by surgical removal of the ovaries (oophorectomy) in premenopausal women may be restored with the use of testosterone or a combination of testosterone and estrogen. For example, research suggests that fluctuations in the level of testosterone in young women has no particular effect on sexual desire. This feeling of well-being provides a healthier outlook and potentially allows the woman the chance to increase her interest in sex. Certainly, the age of the women experiencing the surgery along with the reasons for a hysterectomy can be important variables contributing to sexual adjustment after surgery. This testosterone and androgen production is obviously not available to women whose ovaries have been removed. As we saw earlier, post-menopausal ovaries stop the production of estrogen, while they do however produce measureable quantities of testosterone and other androgens from the ovarian tissue. When simultaneous removal of the ovaries (oophorectomy) is performed on a premenopausal woman, her available estrogen, as well as testosterone, are suddenly dramatically lowered with the possible impacts already mentioned from the role of these particular hormones. Some women may possibly be troubled by the loss of uterine contractions and a diminished total vasocongestion at the time of arousal. For example, scar tissue may possibly prevent full ballooning of the vagina, which could make intercourse more difficult. In theory, a small percentage of women may experience some physiologic differences in sex after removal of the uterus.

When a relatively longterm sexual or emotional adjustment is required following a major surgical procedure, it's always best to involve the partner in the preoperative discussions. It is very important for the physician to outline what sexual activities are permitted after the surgical procedure and which ones are prohibited and for how long. Postoperative discomfort and pain and some small amount of bloody secretions and discharge may be expected by the physician, but often causes alarm and considerable anxiety for the woman and her partner. Without question, surgical procedures in the female genital area will have sexual implications. What is clearly needed is a better understanding of the basic science in this area so that non-hormonal drugs can be developed to improve sexual desire and arousal. Unfortunately, this is still a somewhat controversial area in that there's no clear evidence concerning this particular potential side effect. The most crucial issue is the long-term health effects on women who take androgens, particularly in terms of how they impact the cardiovascular system.