Q: Will I miss my cervix if it's part of a hysterectomy?

Most women have very normal sexual function without a cervix. I have seen reports that suggest an issue, but in 24 years of practice, I can't recall a single woman who was impaired by the absence of her cervix. There are complications that result if the cervix is left after a hysterectomy, including abnormal pap smears and continued bleeding. If there is any remaining endometrium (the membrane lining of the uterus) and you consider hormone therapy in menopause, you will need progesterone as well as estrogen. I've seen women less fond of progesterone than estrogen. Whether you're able to keep ovaries in a hysterectomy is a bigger issue to sexuality—and in fact overall health—for women. Even after menopause, the ovaries continue to produce hormones. Those hormones not only mitigate some of the effects of menopause, but they also promote bone and heart health. There are times when it's appropriate to remove the ovaries as part of a hysterectomy, but the decision needs to be made based on each woman's health and history. Glad you're thinking about your continued sexual health, and good luck with your recovery!

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