Effects of surgery on women

Surgery can affect your sex life in different ways. It may change how you look or how a part of your body works. This can have emotional as well as physical effects. Surgery may affect your physical ability to have sex. But any surgery might affect how you feel and think about yourself sexually, and this can have an impact on your sex life.

There are different types of surgery that might have a physical effect your sex life. These include:

  • surgery to remove both ovaries
  • surgery to remove the womb or cervix
  • surgery to remove part or all of the vulva
  • surgery to remove the bladder
  • surgery to the anus and rectum.

Each of these types of surgery will have different effects on your sex life and sexuality. Your hospital team can tell you more about what to expect and what will help manage the effect on your sex life.

How cancer treatments may affect your sex life

Cancer and cancer treatments can affect your sexual function directly or indirectly. Direct effects can be caused by treatments that affect the sex organs or sex hormones. Indirect effects can be caused by side effects like tiredness, or by changes in a part of your body other than your sex organs.

It is important to remember that not everyone will have the side effects we mention. Your cancer doctor or nurse can answer any questions you may have about your treatment, and how it might affect you.

Effects of surgery on your sex life

If surgery changes how you look or how a part of your body works, this can have emotional as well as physical effects. Some types of surgery may not affect your physical ability to have sex, but could affect how you feel and think about yourself sexually. If surgery affects how a part of your body works, you may need to make adjustments to your sex life.

Surgery to organs in the pelvic area may cause noticeable changes to your sex life. Your surgeon and specialist nurse will talk to you about the surgery and how it might affect you. Sometimes, nerves that are important for sexual function may be affected. If this happens, it can cause changes in arousal, orgasms and vaginal wetness. Nerves may gradually recover in the months following surgery, but in some women the changes last longer.

Surgery to remove both ovaries

An operation to remove both ovaries is called a bilateral oophorectomy. Sometimes the ovaries are removed during other operations too.

Removing the ovaries can affect sexual function in women who have not gone through a natural menopause.

Surgery to remove the womb or cervix

An operation to remove the cervix and retain the womb is called a radical trachelectomy. It may be used to treat very early cervical cancer.

The most common operation where the womb and cervix are removed is a radical hysterectomy. But the womb and cervix may be removed during other operations too. Your surgeon would always talk this over with you before the operation.

If the womb is removed, womb contractions will no longer happen at orgasm. For some women, this can change how their orgasms feel.

The upper part of the vagina may be removed with the womb and cervix. This makes the vagina shorter. Having a slightly shorter vagina is usually not a problem. The vagina is naturally stretchy and expands when you become aroused, so the change may not be noticeable. But some women find that penetrative sex in certain positions is uncomfortable. There are different ways that you make sex more comfortable.

Surgery to remove part or all of the vulva

An operation to remove part of the vulva is called a partial vulvectomy. Rarely, the whole vulva may be removed. This is called a total vulvectomy.

Surgery to the vulva may be used to treat cancer of the vulva. Your surgeon will talk to you about the type of operation you will have, and what to expect.

This operation may cause some numbness in the part of the vulva where the surgery was done. Some women also have numbness in the tops of their legs. Some feeling may come back in the months after the operation.

If the clitoris is removed, this will affect sexual sensations and orgasms. But orgasm may still be possible.

Surgery to the vulva might cause scarring, and the vulva may look different from before. You may be worried about how your partner or future partners may respond to changes in your vulva.

Surgery to remove the bladder

An operation to remove the bladder is called a cystectomy. The surgeon may also remove the womb, ovaries, part of the vagina and the tube that drains urine from the bladder (urethra). This is called a radical cystectomy. The surgeon will explain this to you before the operation.

If your urethra is removed, the end where it opens outside the body may also be removed. This can affect the blood supply to the clitoris, making it less responsive to arousal. The end of the urethra is not always removed. Your surgeon can advise you about this.

When the bladder is removed, your surgeon can often make a ‘new’ bladder. If this is not possible, they will make an opening in the wall of the abdomen (a stoma) so that urine can drain into a bag.

Surgery to the anus and rectum

After an operation to remove the rectum, penetrative vaginal sex may be uncomfortable in some positions. This is because the rectum is behind the vagina, and normally cushions it. You may need to try different positions to find which ones are best for you.

Surgery to remove an anal or rectal cancer may affect your sex life if you enjoy receptive anal sex or anal play.

If you have a type of operation called an abdominoperineal resection, the entrance to the anus will be surgically closed. This means anal sex is no longer possible. Bowel motions pass out of the body through an opening (stoma) in the tummy.

After some types of surgery for bowel cancer, a stoma is made but the anus and part of the rectum are left in place. The remaining rectum is surgically sealed and is no longer connected to the rest of the bowel. This leaves a ‘rectal stump’. It may still be possible to have receptive anal sex or anal play after the wounds from your operation have fully healed. This depends on the depth of the rectal stump. It is important to check with your surgeon before attempting this.

Effects on sex hormones

Treatments that affect the balance of sex hormones in your body can also directly affect sexual function. These include treatments that affect the ovaries, and hormonal treatments for some breast and womb cancers.

If the balance of hormones is affected, it can cause menopausal symptoms. These include:

  • hot flushes and sweats
  • vaginal dryness
  • passing urine more often
  • lower interest in sex
  • aches and pains
  • mood swings and poor concentration.

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The female body and sex

Cancer can affect your sexual desire and arousal. Knowing women’s sexually sensitive areas and how your body behaves may improve your sex life.