Predictive value of psychatric history, genital pain and menstrual symptoms for sexuality after hysterectomy

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Abstract
To study the predictive value of the history of genital pain, psychiatric complaints and menstrual symptoms on a woman's sexual life before and after subtotal hysterectomy. One hundred and four premenopausal women were interviewed one month before and one year after surgery. A latent variable for pre- and postoperative sexuality was constructed from the intercorrelation between the measured parameters of frequency of desire for sex, coital frequency, cyclicity of desire and existence of multiple orgasm, and other variables for genital pain, psychiatric morbidity and menstrual symptoms were compared to the latent factors for sexuality. No difference was seen in postoperative sexuality in women with and without a history of psychiatric complaints. The regular use of analgetics, a need to stay home from work because of menstruation, and the occurrence of dyspareunia were positively correlated to the latent factors for sexuality before and after the operation. A history of the need to use psychopharmaceuticals, such as sedatives or antidepressants, had a negative influence on preoperative, but not on postoperative sexuality. Dysmenorrhea had a positive influence on postoperative, but not on preoperative, sexuality. Among variables studied, dysmenorrhea was the best predictor for postoperative sexuality. That is: women with dysmenorrhea do not only invariably experience relief from the pain, but also have a chance to improve their sexual lives after removal of their malfunctioning uterus. Presence of psychiatric problems had, in general, little influence on sexuality.