It was the second time I was meeting Lucy at the Sexology Clinic. The first time, she was 30 years old and had just got married. At that time, she was experiencing painful intercourse.
After several sessions with her and her husband, it became apparent that they lacked sexual expertise and frequently engaged in penetrative intercourse without sufficient lubrication. This resulted in bruising and pain for her. After several sex coaching sessions, the couple became proficient.
But that was now water under the bridge. Nearly 15 years later, Lucy returned with a different problem. She had just been diagnosed with early-stage cervical cancer. She was fortunate that the cancer had not spread. She had just celebrated her 44th birthday. Her marriage had remained blissful since our last meeting. Over the years, she had given birth to three children.
"I'm so sorry to hear about your diagnosis, but I'm glad the cancer was detected early," I said, trying to reassure Lucy.
I have noticed that people tend to be rather concerned when they are told they have cancer. It's important to remember that not all cancers are fatal, and early diagnosis and treatment can significantly alter the course of the disease. Many people are cancer-free after successful treatment.
"Well, I'm not actually worried about the cancer," Lucy interjected. "It's the thought that I might never have sex again that worries me."
Incidentally, Lucy had been told that she would have to undergo a hysterectomy — an operation in which the uterus is removed. The gynaecologist gave her two options for how the operation could be performed: either by cutting her stomach or through her vagina. She was given a few days to decide and then come in for admission.
“My gynaecologist didn't explain what would happen to my sex life afterwards. Do you know any women who have had a hysterectomy? Do they still have sex and enjoy it?” Lucy asked.
Hysterectomy is actually the most common major gynaecological operation that women undergo. Consequently, many women have undergone the procedure, including those in marital relationships. At one time, it was thought that the uterus played a significant role in sex and orgasm. In fact, gynaecologists would perform sub-total hysterectomies, leaving the cervix in place, to enhance sexual pleasure.
However, these beliefs have been scientifically disapproved. Compared with women who have not undergone a hysterectomy, those who have actually have a higher libido. On average, women who have undergone hysterectomy have sex more frequently than women of a similar age who have not.
Arousal and lubrication are not affected by hysterectomy. The glands that produce lubrication are not found in the uterus, so women enjoy foreplay and get the desired lubrication with or without the uterus.
There has also been a fear that women who have undergone a hysterectomy may have a shortened vagina, which could affect sex. However, this is not the case. There is no difference in pleasure for either partner after a woman has undergone a hysterectomy.
“But doctor, all this does not matter if you do not experience orgasm, especially vaginal orgasm!” Lucy interjected. Her friends had told her that she might never experience an orgasm that comes from deep inside and that she would have to make do with clitoral orgasms.
But that is far from the truth. A hysterectomy does not interfere with the G-spot, the most sensitive area of the vagina from which vaginal orgasms arise. Women who have had a hysterectomy continue to enjoy both vaginal and clitoral orgasms.
In these cases, the type of operation does not affect sexual function. A hysterectomy can be performed by making an incision in the abdomen to access the uterus, which is then removed in a similar manner to a baby during a caesarean section. Alternatively, the uterus can be accessed via the vagina, separated from the surrounding organs, and pulled out without any abdominal incision. Regardless of the method used, sexual function remains intact.
“I have now made up my mind. I will go for the hysterectomy and join the league of women who enjoy sex without worrying about cervical cancer or monthly periods,” said Lucy as she waved me goodbye to go and face the surgeon’s knife.
Six months later, I received a call from Lucy.
"Our sex life is back to its peak again! It looks like nothing can stop our love, not even a hysterectomy," she said, bursting out laughing.
