Sexual changes in surgical menopause

For many of us, the connection with our sexual selves is interrupted temporarily after surgery. Hysterectomy and oopherectomy both can cause a loss of libido and desire. For some women, the changes are long term, and can be life-changing. Unfortunately, this is an area where women are especially inadequately prepared before surgery, and the change to our sex lives and intimacy in surgical menopause can take some time to process. Let’s look at some of the changes reported by women after oopherectomy.

Loss of libido

Testosterone plays a key role in sexual desire, and its sudden loss after surgery can switch off your interest in sex and intimacy almost overnight.

  • Lack of spontaneous desire or fantasy

  • Feeling indifferent or anxious about sex even with your regular partner

  • Emotional disconnection from your partner

  • Deliberately avoiding moments of intimacy

Reduced arousal

Even when you want to be close, your body may not respond in the same way. Reduced blood flow and nerve sensitivity can make arousal slower, and vaginal dryness can cause discomfort or pain. It’s important to remember that intimacy doesn’t always mean sex.

  • Difficulty becoming physically aroused or a feeling like you can’t quite get ‘there’

  • Longer time to reach pleasure, including during masturbation

  • Decreased genital sensitivity when being touched or masturbating

  • Not feeling ‘wet’ or ready for sex

  • Loss of enjoyment during foreplay or a feeling of being less turned on

A hand holding a halved red grapefruit against a coral pink background.

Changes in orgasm

Many women notice that their orgasms feel different after surgery — less intense, muted, or harder to reach. This can be related to your surgery, especially if your uterus was removed (hysterectomy), or you have scarring build up over time. Some women who have had their cervix removed feel that the sensation of orgasm changes.

  • Loss of uterine or deep pelvic contractions

  • Duller or more distant sensation

  • Difficulty reaching climax or needing more stimulation

  • Feeling ‘different’ or emotional after orgasm

  • A sensation of your orgasm ‘travelling’ differently around your body

  • Inability to achieve orgasm when self-pleasuring

Painful intercourse (dyspareunia)

Thinning and dryness of your vaginal and vulvar tissue can make vaginal penetration painful, and leave soreness or stinging afterwards. Over time, this can make you anxious about penetrative sex.

  • Sharp pain on entry or a feeling of ‘tearing’.

  • Burning feeling after sex, or stinging when peeing after penetration.

  • Bleeding when wiping after intercourse or digital penetration.

  • Pain ‘deep’ inside during thrusting

  • Aching inside after penetration

  • A throbbing sensation deep inside that lasts for hours after sex

  • Avoidance of intimacy due to fear of pain