Answer:
by Megan P Fleming: (05/27/2004)
It is not uncommon for women to experience difficulties with sexual arousal after a total hysterectomy. Unlike a hysterectomy in which only the uterus is partially or totally removed, a total hysterectomy involves surgical removal of both ovaries causing the sudden loss of their estrogen and androgen production, and the onset of menopause. Despite taking Premarin, an estrogen replacement therapy, you continue to report an estrogen deficiency symptom- decreased vaginal lubrication, and a testosterone deficiency symptom- decreased genital sensation. I would recommend speaking to your Gynecologist and having your hormone levels checked, as there are a number of treatment options. She/he may recommend a higher dose of your current medication, or another hormone replacement therapy (HRT). Estratest is a form of HRT that combines estrogen and testosterone. Other options might include use of an estrogen and/or testosterone cream that would be applied directly to your vulva. In the meantime, if you have not already done so, I would recommend trying a vaginal moisturizer, like Replens, which is designed to moisturize the walls of the vagina, and can be used 3 times a week. In addition, prior to vaginal penetration, either you or your partner can apply a water-based lubricant, such as KY liquid or gel, Astroglide, Moist Again, or Probe to name a few. You mention that Kegel exercises have helped, and I would recommend practicing these exercises daily. Many women report that voluntarily tensing the vaginal and perineal muscles just prior to a sensation of climax helps initiate orgasm. Finally, for an optimal sexual experience don’t rush the amount of foreplay, you want to give yourself time and enough psychological and physical stimulation to develop your fullest level of arousal. Reviewed by Sexual Health Editorial Team
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