HYSTERECTOMY: OVERCOMING PROBLEMS OF SEXUAL FUNCTION
A hysterectomy is often seen as a last resort by women who have uterine or menstrual symptoms that are making their lives, including their sex lives, a misery. Chronic pelvic pain and protracted menstrual bleeding, for example, may mean that prior to a hysterectomy a woman’s sexual needs and those of her partner are not being met. This can lead to unhappiness on all sides. A great deal of hope may be vested in the prospect of an improved relationship after hysterectomy, including an improved sexual relationship. If symptoms do not resolve quickly or new symptoms appear which continue to stymie efforts to reinstate a sexual relationship, feelings of depression may mount. Existing difficulties in a relationship may became more acute with outbursts of hostility and anger an increasingly frequent event. Short-circuiting this situation is not easy, but it may be achieved if partners can bring themselves to try pleasuring activities like massage, mechanical stimulation and mutual masturbation. In this way the very important communication that occurs via all the senses, and especially touch, can be developed.
Sexual interest, indicated by sexual arousal, sexual fantasising and masturbation, becomes apparent in females and males during the early teenage years. Then, as sexual interest matures in later adolescence, most individuals develop quite specific erotic fantasies. The ability of humans to create and respond to fantasies seems to play a major role in sexual motivation and in sexual receptivity. Strong and deliberate fantasising through erotic stories, pictures, readings and films may help stimulate this interest. Such strategies may help rekindle sexual interest.
Like most species, humans work up to sexual contact with foreplay that excites both partners. Birds coo, bow and strut. Primates spend hours grooming each other. In most mammals, delicate stimulation of sensitive body parts is an important component of stimulatory activity
preceding sex. Many couples find that taking the time to gently and lovingly play with the clitoris, penis, and the nipples, using the fingers, the tongue or a vibrator, can arouse intensely pleasurable sensations. If arousal takes a long time, accept this and continue the activity only as long as you are both enjoying the experience.
There is some evidence to suggest that techniques of sexual intimacy have changed in recent generations with increases in oral sex in marriage, more variation in foreplay and more experimentation with positions. Some women enjoy deep penile penetration and may achieve this by either the female-astride position, or the man-on-top position with her legs on his shoulders and pillows under her hips. Adequate vaginal lubrication is an important consideration and can be achieved using substances such as K-Y jelly or the new hormone-free Replens which lasts for several days and is not messy. Many women find that post-menopausal hormone therapy helps lubrication.
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