Doctor's Advice - Should I get a hysterectomy?

Q. Doc, I am in a 'war of words' between my husband and my doctor. My doctor wants me to have a hysterectomy, but my husband is saying that I cannot, because that would mean the end of our sex life. Sex is very important to him. And I must admit, doctor, that I also like it a lot. I, too, have some doubts about taking this operation. I have heard from friends that it gives you hot flashes and makes you feel really horrible - like having a sudden menopause. I would not like that. What do you think, Doc? Should I go ahead and have the surgery?

A. I feel there have been a few misunderstandings in your family. To begin with, let's get it clear what a hysterectomy is. It is the removal of the womb (also known as the uterus). That is done for various conditions, such as fibroids and disorders which cause heavy bleeding.

Now I cannot overemphasise the fact that, if you have a hysterectomy, that will not mean the end of your sex life. After all, sexual intercourse is something that involves the vagina. It doesn't really involve the womb. Sexual pleasure and orgasms are largely functions of the clitoris. In a hysterectomy, the surgeon does not go anywhere near the clitoris!

There are various types of hysterectomy surgery, but most of them will leave you with a perfectly normal vagina, which will work just fine when you resume sexual intercourse. Admittedly, you will have to wait a while before resuming sex so that the stitched areas can heal properly.

As it relates to menopausal symptoms, here again, there has been a slight misunderstanding. Removal of the womb does not cause sudden menopause. It is actually removal of the ovaries that causes sudden and violent menopausal symptoms. Admittedly, gynaecologists often remove the ovaries at the same time they are doing the hysterectomy. But you should tell your doctor you do not want your ovaries removed, unless for some medical reason it is absolutely necessary.

Before you do this operation, you will first need to see a gynaecologist who has to decide whether you really need to do the operation or not. My best suggestion is that you should now discuss what I have said with your husband. Then see the gynaecologist and discuss everything carefully before you decide. Good luck.

Q. My wife is cold and frigid, so we very rarely have sex. As a result, I am thinking of going to the Corporate Area soon and hiring a call girl.  But Doc, what would be my chances of catching a venereal disease?

A. I am very sorry to hear about your marital situation. But I am not sure that getting a prostitute is the best answer. After all, it would only be a temporary remedy for your sexual frustration.

Anyway, if you do go ahead with your plan, much depends on the socio-economic status of the woman in question. If she is at the 'bottom of the pile', and is operating on a street corner, there is a very high chance that she will have some sexual infection. These women are likely to be having sex with half a dozen men per night, so it is not surprising that they tend to acquire some germs.

Then there are the 'de luxe' girls who operate out of ritzy premises and hotels. They have a much smaller client list and I believe many of them do get good medical care. But even these women do get sexually transmitted infections (STIs) from time to time.

So you see, going with a commercial girl in the Corporate Area is fraught with danger. If, despite what I have said, you decide to do it, I urge you to use a condom. However, I can see an alternative strategy. Your marriage appears to be miserable and virtually sexless at the moment. So it would be a good plan to try and get your wife to agree to some kind of marital counselling. The two of you could go to a good therapist or counsellor and have some sessions which could just conceivably save your marriage. But if that doesn't work, then I think you have to consider bringing this sad relationship to an end.

Q. Doc, my vagina has become quite dry recently, and this is making sex difficult. Would going on the Pill help?

A. Probably not, though it might be worth trying it for a few cycles. Really, you need a check-up from a doctor to see what is the reason for this dryness. If she finds any hormone deficiency in that area, she will probably prescribe a vaginal hormone cream that will help your situation.

If she says that you do not actually have any medical condition, then the simplest way to correct matters would be to get yourself a good vaginal lubricant. These are on sale in all large pharmacies. And you can find a much wider selection on the Internet by just Googling 'sex lubricants'. You will find a remarkable 4.3 million entries.

Q. After 20 years of marriage, my wife has suddenly started climaxing, and even doing it more than once.  I am worried, doc. Does this mean she is cheating on me?

A. Not at all. Many women suddenly discover, after many years of marriage, that they have much more orgasmic capacity than they thought. I would suggest that your wife finds you very attractive and that whatever you are doing to her in bed is very skilful and successful. Rather than worrying, I think you should congratulate yourself.

Q. I am considering getting pregnant, but would the fact that I am overweight cause me to have problems in giving birth?

A. Well, recent research has confirmed that overweight and obese women have an increased risk of difficulty for themselves and their babies. So if you can, it would be a good idea to try and lose some weight before you get pregnant.

Q. Doc, my new wife is a very sexy woman and she wants me to have intercourse with her from behind. Could this harm either of us?

A. I assume you are talking about vaginal sex, rather than anal sex. Sexual intercourse in what is often called 'doggy style' is totally harmless to both parties.

Send questions to deardoc@gleanerjm.com