Hysterectomy and sexual wellbeing
http://www.100md.com
《英国医生杂志》
EDITOR—We emphasise that we never intended to suggest that hysterectomy might be a treatment for sexual problems. Indeed, our study does not predict improvement for every individual woman.
In contrast to Bradford's interpretation, we directly measured sexual satisfaction (methods section, p 775). In the appendix we presented only the questions of the questionnaire that assessed problems during sexual activity.
The reason that we presented only the results concerning women with a male partner is that the number of women with a female partner or without partner was too low to allow a well powered statistical analysis. So the results of our study are applicable only to women who have a male partner.
We did not study in detail whether the change in sexual activity before and after hysterectomy was related to the operation performed or to other circumstances in life. As we did not study it, we prefer not to speculate about a possible relation to hysterectomy.
With respect to bilateral oophorectomy, this procedure was simultaneously performed in only 3.8% of the study group. All premenopausal women who underwent hysterectomy and bilateral oophorectomy were given hormone replacement therapy.
If the indication for hysterectomy is well considered, the patient is severely bothered by the symptoms. On the basis of fear of worsening sexual wellbeing, patients may avoid a treatment that could be very effective. Our study shows that doctors can tell patients who have this fear that in general sexual wellbeing will improve.
Ignoring the results of this prospective study, and continuing to base counselling on less well developed studies, does a disservice to women.
Jan-Paul Roovers, registrar
j_proovers@hotmail.com
C Huub van der Vaart, consultant, A Peter M Heintz, professor of gynaecology
Department of Obstetrics and Gynaecology, University Medical Centre Utrecht, 3584 CX Utrecht, Netherlands
Johanna G van der Bom, assistant professor of epidemiology
Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht
Competing interests: None declared.
Related Articles
Hysterectomy and sexual wellbeing: Data were misrepresented
William H Parker
BMJ 2004 328: 107.
Hysterectomy and sexual wellbeing: More questions are yet to be answered
Andrea Bradford
BMJ 2004 328: 107.
Hysterectomy and sexual wellbeing: prospective observational study of vaginal hysterectomy, subtotal abdominal hysterectomy, and total abdominal hysterectomy
Jan-Paul W R Roovers, Johanna G van der Bom, C Huub van der Vaart, and A Peter M Heintz
BMJ 2003 327: 774-778.
In contrast to Bradford's interpretation, we directly measured sexual satisfaction (methods section, p 775). In the appendix we presented only the questions of the questionnaire that assessed problems during sexual activity.
The reason that we presented only the results concerning women with a male partner is that the number of women with a female partner or without partner was too low to allow a well powered statistical analysis. So the results of our study are applicable only to women who have a male partner.
We did not study in detail whether the change in sexual activity before and after hysterectomy was related to the operation performed or to other circumstances in life. As we did not study it, we prefer not to speculate about a possible relation to hysterectomy.
With respect to bilateral oophorectomy, this procedure was simultaneously performed in only 3.8% of the study group. All premenopausal women who underwent hysterectomy and bilateral oophorectomy were given hormone replacement therapy.
If the indication for hysterectomy is well considered, the patient is severely bothered by the symptoms. On the basis of fear of worsening sexual wellbeing, patients may avoid a treatment that could be very effective. Our study shows that doctors can tell patients who have this fear that in general sexual wellbeing will improve.
Ignoring the results of this prospective study, and continuing to base counselling on less well developed studies, does a disservice to women.
Jan-Paul Roovers, registrar
j_proovers@hotmail.com
C Huub van der Vaart, consultant, A Peter M Heintz, professor of gynaecology
Department of Obstetrics and Gynaecology, University Medical Centre Utrecht, 3584 CX Utrecht, Netherlands
Johanna G van der Bom, assistant professor of epidemiology
Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht
Competing interests: None declared.
Related Articles
Hysterectomy and sexual wellbeing: Data were misrepresented
William H Parker
BMJ 2004 328: 107.
Hysterectomy and sexual wellbeing: More questions are yet to be answered
Andrea Bradford
BMJ 2004 328: 107.
Hysterectomy and sexual wellbeing: prospective observational study of vaginal hysterectomy, subtotal abdominal hysterectomy, and total abdominal hysterectomy
Jan-Paul W R Roovers, Johanna G van der Bom, C Huub van der Vaart, and A Peter M Heintz
BMJ 2003 327: 774-778.