Hysterectomy Stories: A woman and her decision about her cervix

We have discussed sexuality after a hysterectomy before, but some women feel that part of a discussion on sex after a hysterectomy should include a decision regarding whether to keep your cervix. Interestingly keeping the cervix was a normal part of the hysterectomy operations in the early part of the 20th century, but by 1960, as a way to control cervical cancer, and other reasons, gynecologists began to recommend that the cervix be routinely removed at the time of a hysterectomy. Although under the microscope the cervix and uterus have different tissue compositions, the fact is that the cervix and the top portion called the uterine fundus, actually make up a single organ, and the surgery is usually more effective and in some ways more straightforward if both the cervix and the uterus are removed together. So as for the pros and cons of taking the cervix: on the pro side:  fewer cases of cervical cancer and the con side: removing the cervix disrupts some pelvic support and the surgery in that region is near both the bladder and the bowel. But in the 1980s Scandinavian researchers put forth the idea that sexual function is preserved better if the cervix was left. This early proclamation was not backed up by study, but by patient reports. When the studies of sexual function were done not all the work looked at all aspects of sexuality. Most women who had a good sex life after their hysterectomy, had a good sex life before their hysterectomy. So if you are having gynecologic problems, and sexuality problems, if you need a hysterectomy to fix the gynecological problems, you likely will need other treatments to treat your sexual function. Leaving the cervix will not really change the way you approach sex.

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