Sexuality--the mature or childbearing years and the effect of gynecologic surgery
Chapman, J.D.
Journal of the American Osteopathic Association 78(7): 509-514
1979
ISSN/ISBN: 0098-6151 PMID: 429226 Document Number: 468775
Little is written about a woman's sexuality and the changes it may undergo when gynecologists assault the pelvis, the woman, and the individual with their armamentarium and surgery. This paper examines, to a limited degree, such sexual sequelae in women in the mature or childbearing phase of life. The data presented are derived from the history and physical examination of surgical patients seen in a private office gynecologic practice from the fall of 1972 to the fall of 1977. The attempt was made to include in all clinical histories a sexual history with at least as much depth as that acquired in the system review of a good history. Sexual histories were obtained from 79% of the patients over this period. Of the 986 patients from whom a sexual history was obtained, a 6 or more month follow-up was made in 69% or 671 patients. In this follow-up the same inquiry was made at intervals from 6 months up to 38 months. 187 students in a university and office complex in the relative area served as the control group and were asked the same questions as the surgical population by a research associate. Questions covered the following: whether orgasm was achieved; the manner in which orgasm was achieved; masturbation; the importance of sex; the variability of sexual appetite; faking orgasms; and preferences of sexual stimuation. The significant changes seen among women who had undergone a laparoscopy after the longterm evaluation were in faking orgasm and in seeking different outlets for sexual gratification. Faking orgasms decreased 60%. Preoperatively, all women reported that they had or did fake orgasms. 6 months postoperatively the women were more honest sexually and would not pretend. At this point women had no sexual stimulatory preference. The data illustrate that laparoscopic sterilization does not produce a radical change in women's sexual responses other than a release from pretending and greater sexual freedom in acting out what pleases them. The next procedure studied was hysterectomy. This procedure had great impact on the minds and emotions of these women. During the first 6 weeks after surgery, 80% of the women were devoid of sexual feelings and most expressed this as a fear of being hurt by just about anything. The 20% who were in touch with their sexual feelings varied from a few patients who masturbated to orgasm while still in the hospital to the remainder of patients who masturbated to orgasm by the 6th postoperative week. The postoperative prohibition against sexual relations was a stimulus to the libido of these women. At the 6th month period and later, there developed a stable plateau. 78% of the women stated that they were orgasmic compared with 76% in the preoperative history. The greatest change was noted among the women who had undergone colporrhaphy. 60% of the women were orgasmic after 6 or more months postoperatively compared with 76% preoperatively. They attributed this for the most part to failure to achieve pleasure through vaginal penetration, which had either been ancitipated or suggested.