His and Her Health

I keep hearing how great sex is after hysterectomy, but that is not my case. I am 49 & had a full hyst. 3 yrs. ago. Since then, my drive is so low & nothing is like it was before. The only way I can achieve orgasim is w/a vibrator & it takes so so long!! My dr. didn't seem concerned. She thought I should be happy that I wasn't hemmoraging every month, which I am - but I never expected this part of my life to change like this. My husband & I have a great relationship & I so want to feel again; however I just don't seem to have the same feelings or sensations that I once had. I feel as though I've lost such a large part of me. I tried testosterone cream but that didn't seem to offer much. Any suggestions or suggestions of how to choose a new gyn dr. that specializes in this. Thanks.

We can't discuss providers here, unfortunately.

Are you on any type of HRT? For many woman who've had a full hyst, the testosterone cream is simply not enough. Your body needs testosterone not only for sexual function, but for things like muscle mass (important as we age). Oral tesosterone may be a better alternative for you. I never understand why docs are so reluctant to do this--post-hyst testosteron replacement is pretty well-studied and acknowledged as valid and helpful at this point.

I have been on HRT right along, currently I am on Cenestin 0.625, but I am honestly thinking of coming off it because for the last 6 months the hot flashes & mood swings have really subsided. I also take Zoloft which I really didn't find to make much difference. I had taken other anti-depressants in the past where the side effects were instant - not so with Zoloft. Will check on oral testosterone. Thanks.

Chiara,

I took Zoloft a couple of years ago, and I had the same problem as you're having now. It took a long time to become aroused, then forever to have an orgasm. Once I stopped the anti-depressants it got better. Since then I've started on estrogen patches and compounded testosterone cream, and my boyfriend is threatening to take the testosterone away from me so he can get some sleep!!
Some women just don't absorb the hormones as well, and oral may be better for you. If you're using a compounding pharmacy for your hormones, as them for the names of doctors in your area that work with them...then maybe switch doctors. Best of luck to you. June

Thanks for your info. I made an app't. today w/my dr., so I'm going to discuss the patch as well as the oral alternative. Not sure what to do about Zoloft though, because that has made a huge difference in how I feel in general. Oh well, nothings ever easy. Thanks again.
Chiara

Have you tried working with a compounding pharmacy? You can do a search online for that and call one near you. They can recommend physicians that work with them and prescribe bio-identical hormones. Sometimes, all you need is some progesterone and estrogen which them can taylor make one for you! best wishes!

Maryan

I have been on Effexor for a couple of years now. This has little or no affect on sex life. Once I got my hysterectomy I suffered from the hot flashes (still do) but my GP put me on Fluoxitine (Prozac) because I smoke. With the combination of the two drugs I can orgasm multiple times.

Different meds affect people differently. This is just what has worked for me.

I also smoke, but am on a low dose estrodiol patch called Vivelle Dot, along with progesterone cream. My previous GYN would not prescribe me anything either for this very reason, but bio-identical hormones react different in your system than conventional therapies. I urge anyone still suffering with menopausal symptoms to reach this more to see if it is right for you.

Hi...brand new here. I am 43 and had total hysterectomy in Dec. 2006. Just had a 6 mos follow up with my gyno and mentioned that I'm having difficulty achieving orgasm and wondered if it was just b/c my anatomy had changed. She told me the Premarin hormone I was on was the equivalent of that found in a 58 year old woman! Well duh~! LOL She upped my estrogen, in the form of Vivelle dot, which I will soon start. I'll be sure to share my progress. I was dumbfounded to learn about the estrogen level being that of an older (albeit not an old) woman. Who makes up these rules! : ) Anyway, just thought this info might help someone...

If you had a total hyst, meaning ovaries removed, at least part of your problem may be loss of testosterone. For some reason, a lot of docs overlook this well-known and widely-accepted issue, and don't prescribe testosterone for women who complain of loss of sexual desire and orgasm after having their ovaries removed.

I've known several women who have had full hysts, and of those who have sexual desire and/or orgasm complaints afterwards, the majority were helped by testosterone therapy. This is anecdotal, but hopefully you can do some research and talk with your doctor.

Following a hysterectomy (removal of the uterus), estrogen levels don't change. But if the ovaries are removed (oophorectomy), then the estrogen making organs are removed and the result is automatic menopause in just a few days.

Premarin is one way to restore the presurgical hormone levels but in a menstruating woman, the sudden removal of the ovaries from a 43 year old requires more estrogen to restore normal levels than the gradual loss of estrogen in a 53 year old woman. Premarin is composed of many estrogens, more than 200, and they don't all show up in blood tests. Vivelle contains only one estrogen and can be measured in total by a blood test for estradiol. It is possible to have either of these equivilant dosages, but the number of milligrams will be different for each, as they are different compounds.

After a year or so, the higher estrogen replacement levels can be lowered gradually in most instances using either one of these hormones as the body gets used to lower dosages.