Hysterectomy is a common type of elective surgery for women. The most common reasons for hysterectomies are to treat conditions such as heavy bleeding, fibroids, endometriosis and prolapse.

A hysterectomy rarely needs to be performed urgently except in those cases involving cancer or uncontrolled bleeding following the birth of a baby. This allows a women who is considering a hysterectomy to review all her options and possible treatments. A hysterectomy is usually only considered when other more conservative treatments are not considered beneficial.

If hysterectomy surgery is performed prior to the menopause and the ovaries are preserved so that their hormone secretion not affected, there may not be a decline in the libido following the surgery healing period. Some women even experience an increase in libido if they were distracted by heavy bleeding or pelvic pain prior to their surgery.

However, evidence has indicated that failure in the ovaries occurs up to 50% of the time during the first three years following the surgery. Should this occur, the libido and other menopausal symptoms will indicate the decrease in hormone levels. Some doctors are unaware of this rate of failure following a hysterectomy and assume that their symptoms are a direct result of the surgery itself.

when the surgery is performed prior to the menopause and the ovaries are removed, the fall in oestrogen and testosterone levels is abrupt and often severe. This type of menopause that is surgically induced nearly always results in a sudden fall in sexual desire.

There are other factors which can affect the libido including relationship problems, certain medications and depressive illness.

Certain anti-depressant can decrease both the libido and the ability to orgasm. They can accomplish this so effectively that they are used as a treatment for obsessive sexual preoccupation and premature ejaculation.

Oestrogen replacement medications that is administered and orally administered contraceptives are absorbed by the gastrointestinal tract and reach the liver in a ‘bolus effect.’ This effect induces the liver to produce more ‘sex hormone binding globulin’ which binds to circulate testosterone leaving the less unbound testosterone available to maintain a woman’s libido.

HRT is very effective in maintaining and restoring libido. Treatment often takes 4 – 6 weeks and knowing this often helps with the situation.

Those women who have a surgical menopause often require testosterone replacement in the oral form as earlier described, although it can be administered intravenously, by gels and creams and subcutaneous implants.