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Menopause, a natural biological process marking the end of a woman's fertility, typically occurs between the fifth and sixth decade of life. This phase is characterized by the exhaustion of the ovarian follicle pool, leading to less responsive ovaries despite the high levels of Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH). The consequential decrease in estrogen production results in symptoms like hot flashes, heavy sweating, headaches, hair loss, muscle pains, vaginal...
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Pelvic floor and sexual function 3 years after hysterectomy - A prospective cohort study.

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Effects of hysterectomy on pelvic floor function and sexual function-A prospective cohort study.

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Sexual function and pelvic floor function five years after hysterectomy.

Catharina Forsgren1,2, Ulrika Johannesson1,2

  • 1Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.

Acta Obstetricia Et Gynecologica Scandinavica
|February 25, 2025
PubMed
Summary
This summary is machine-generated.

Hysterectomy significantly reduces pelvic floor symptoms five years post-surgery. While overall sexual function remains unchanged, sexually active women experience a decline, whereas non-sexually active women report improvements.

Keywords:
abdominal hysterectomyfemale sexual functionlaparoscopic hysterectomyminimally invasive surgerypelvic floor functionrobotic assisted laparoscopic hysterectomyurinary incontinence

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Area of Science:

  • Gynecology
  • Urogynecology
  • Sexual Health

Background:

  • The long-term impact of hysterectomy on pelvic floor and sexual function is not fully understood.
  • Benign hysterectomy's effects on these functions require further investigation.

Purpose of the Study:

  • To evaluate the effects of hysterectomy on pelvic floor and sexual function at a 5-year postoperative interval.

Main Methods:

  • A prospective cohort study followed 242 women for 5 years after hysterectomy.
  • Validated questionnaires (PFIQ-7, PFDI-20, FSFI) assessed pelvic floor and sexual function.
  • Nonparametric statistics and mixed-effects models were employed for data analysis.

Main Results:

  • Pelvic floor symptoms significantly decreased by over 50% 5 years post-hysterectomy (PFIQ-7: 42.5 to 20.3, p < 0.001).
  • Bother and distress from pelvic floor symptoms also reduced significantly (PFDI-20: 69.6 to 58.2, p < 0.01).
  • Overall sexual function showed no significant change (FSFI: 17.9 to 18.1, p = 0.73).
  • Sexually active women pre-surgery reported a decline in sexual function (FSFI: 25.2 to 19.6, p < 0.001).
  • Non-sexually active women reported improved sexual function post-surgery.
  • Preoperative pelvic floor dysfunction correlated with lower sexual function (p < 0.05).
  • Hysterectomy route, age, and delivery history did not impact outcomes.

Conclusions:

  • Hysterectomy leads to significant improvement in pelvic floor symptoms 5 years postoperatively.
  • Sexual function remains stable overall, but declines in previously active women and improves in inactive women.
  • Symptom relief from surgery may explain improved sexual function in non-sexually active individuals.