Will My Sex Life Be Lost When I No Longer Have a Uterus?

I’m a lesbian erotic writer having a hysterectomy and I’m uncertain how this necessary medical procedure will affect my sexual desire and intimacy

Photo by Rebecca R on Unsplash

When I think about my burial, I imagine my body as an empty husk, pillaged of its organs. I’m already missing a few: red-raw, swollen tonsils and adenoids extracted from me as a too-young-to-consent six-year-old (I was promised soothing jelly and ice cream afterward but was given scratchy cornflakes instead); and my scarred and infected gallbladder wrestled from my body forty years later (all I wanted after that was a nice cup of tea).

In just a few short weeks, a surgeon will be back inside my body; this time, my uterus is for the chop. I bargained with the gynecologist over the fate of my cervix. Removing it, he told me, and the resulting vaginal cuff (where they sew up the top of the vagina, creating a stitched tube to nowhere) would be more of an issue if I were having heterosexual penetrative sex.

Oh, I thought, are you assuming that my wife and I don’t fuck? That my sex life is limited solely to outercourse? Or do you mean that a man can’t be trusted with his penis? That a post-operative, cervix-absent vagina is not at risk from penetration per se, but is in danger if there’s an inconsiderate dick in the picture?

The same surgeon had previously freaked me out by suggesting that my uterus, plus the large fibroid attached to it, could be pulled out through my vagina. I checked the relative dimensions online: it would be like giving birth to the head of a full-term baby but without the natural processes of loosening pelvic ligaments and cervix dilation.

On review of my scans, he threw me another curveball: given its still increasing size, the only way to get the fibroid out of me would be via “open extraction.” Or, as I explained in a text message to a friend later that day, “He’s going to cut me open and scoop it all out.”

Did you know that fibroids are measured in fruit units? They range from grape size to strawberry, peach, orange, grapefruit, and watermelon—the mother of all fruity fibroids. That’s a veritable feast taking up home where the sun don’t shine and putting pressure on all the surrounding organs and structures.

“Pressure symptoms” is how the gynecologist described it, refusing to accept my use of the word “pain.”

It’s not just pain; my poor bladder bears the brunt of having a large grapefruit pressing on it at all times. My lower back aches and groans as my body twists to compensate for the extra bulk and weight. My osteopath calls it “hormonal belt pain.” Funny how she has no qualms about using that word.

You’d think I’d be happy to know my fibroid’s days—and, by association, those of my uterus—are numbered. I am grateful that I’ve been able to access treatment (and I acknowledge my privilege of having healthcare professionals on the case) but, mostly, I’m cross.

I’m cross that another part of me is going to be cut out and discarded.

I’m cross that I’m not able to cope with my current daily pain and discomfort.

I’m cross that I can’t go for a walk without the reassurance of a toilet (or several) on my route.

I remember a therapy exercise about peeling back the layer of emotion to uncover what’s underneath. The old, many-layered “onion” metaphor. (At this rate, I’ll have enough produce for a greengrocer’s stall by the end of this essay.)

Beneath my crossness—and for clarity, it’s not anger; I’m irked more than rage-filled—I’m “daunted.” Not scared. Not anxious. Not nervous (yet). But daunted. Unsettled. Uneasy.

My uterus has never been a womb. It’s never carried a baby and I’ve never wanted it to. I’m not attached to it as some emblem of my femininity or womanhood (neither of those terms resonate with me either). I’ve never thought of myself as having a “reproductive system,” but I do very much regard this part of me as sexual.

But despite never having created a “new life,” my uterus is also very much linked to how I experience myself as a creative person. More so, perhaps, because the main outlet for my creativity in my adult years has been through writing erotica.

If I’m being honest, as well as feeling daunted about how I’ll manage the physical recovery from surgery, I’m daunted about how it might impact my sexual self.

I Googled “lesbian hysterectomy support” and I’m pretty sure the SEO on this essay will get me close to the top of the search list, given how little information there is out there for this subset of the population. (Side note: the main story online is about an Irish lesbian being denied a hysterectomy in case she found a husband one day…) (Second side note: I am, however, heartened at the plethora of information for those seeking hysterectomy as gender-affirming care.)

As a Venn diagram, my story would have (onion and grapefruit-sized) circles to show that I’m in my 50s, I identify as a queer and kinky dyke, I’m a multi-published erotic writer, I’m childless by choice, I bruise and scar easily, and my past surgery experiences were problematic. I don’t react well to general anesthetic and, previously, I have woken up inconsolable, sobbing and shaking uncontrollably, with my blood pressure through the floor. Not only that, but also my body felt violated and my energy/aura/psyche punctured and displaced. (Oh yes, add my spiritual beliefs circle to the Venn diagram too.) Mine is maybe not a common intersection, but I very much doubt it’s unique.

The first time my wife and I went to see this gynecologist, we wore professional garb. It felt important to show some kind of power and authority while we met with the man who might one day reach inside me. He was charming and confident. We rushed home to change into comfier clothes and to dissect the conversation.

I’d asked him outright about sexual function after hysterectomy and he’d said that many women find it improves their sex life because the symptoms that led them to surgery (often heavy bleeding) have been resolved. I also asked him about cervix retention and sexual sensation. It depends, he said; with or without hysterectomy, many women find that their pleasure comes mainly from external stimulation. Whether or not the ovaries can be spared is one of the main factors related to libido.

There are potential risks of damage to the bladder, urethra, and bowel during surgery. Plus, the risks associated with any surgery and general anesthetic.

“It’s about quality of life,” my wife reminded me. “We’re like the boiling frog; the changes have been incremental and I don’t think either of us realized just how limiting this would become. It’s time.”

She’s right. Over the last year or so, I’ve become increasingly reluctant and unable to do many of the things I love. Long walks on coastal paths were one of the first to go. We’re still having sex but it’s infrequent and tempered with caution and concern for my “ladyparts.” For my birthday last year, my wife bought me a mini hot water bottle with a belt attached so I can wear it when the pain is bad. We jokingly refer to it as my “strap-on.”

Having decided to go ahead with the hysterectomy, I’m left with a deep need to reconnect with my power as a sexual being. If my sexual self might change, how can I find peace with that? If my creativity might suffer (even if temporarily), how can I be okay with this different version of me?

I asked a friend who does Shamanic work if he would support me in creating a small ritual to honor the loss of my uterus; he agreed. As a uterus-free transman, he knows something about releasing body parts.

I also reached out to other people I know to invite them to share their experiences and Venn diagrams of times when their sex lives have felt disrupted. Sexual awakenings, gender transitions, relationship shifts, illness and disability, becoming a caregiver, bereavement, menopause, and aging all feature.

Many of my friends are writers and we’ve created a book of these stories called Sex Meets Life. Collectively, we are cis, trans, and non-binary, straight, queer, pansexual and everything in between. We are in our twenties through to our seventies. We come from at least four different continents. Some of us live with neurodivergence, chronic illness, and disability, and some do not. Sex Meets Life has turned out to be a celebration of diversity and an offering of hope, showing that “imperfect intimacy” is still valid, and that finding your sex life in a state of flux or transformation is a universal experience.

I take comfort in this.

I also take comfort in reminding myself that “you can’t take it with you when you go.” Who cares if my body is an empty husk by the time it’s lowered into the ground or carried on a slow conveyor belt behind the sliding doors at the crematorium? It won’t matter how many organs I have left (and I hope any healthy ones will have been donated anyway). All that matters is finding ways to enjoy my body—and my creativity—today: turning lemons into lemonade and grapefruits into stories that help us all feel a little more connected.

Postscript:

In the time between writing this essay and its publication, I’ve had my hysterectomy.

It went well (thankfully), and I’m mostly feeling liberated and like my world can open up again—even though there is still a question mark over my sex life.

However, throughout the process of preparing, undergoing, and healing from surgery, I continued to find resources and representation for lesbian and queer folk lacking.

In light of this, I’ve written and created some offerings, including more writing on Substack, a video on YouTube, and a Journal to support others with their healing and recovery. You can find all of these resources on my website.

Anna Sansom is a writer and a lover. She previously wrote the Sex/Life pages for DIVA Magazine and her erotic short stories can be found in The Big Book of Quickies, Best Women’s Erotica of the Year, Volume 10, I Write the Body, and scattered across the internet. Her more-than-a-memoir, Desire Lines, “… gives the reader full permission to be themselves…and explore their sexuality with a sense of joy and wonder” (DIVA Magazine). She currently shares her living experiment of queer desire in midlife on Substack, and she is the curator and editor of Sex Meets Life (personal essays and life-inspired fiction from 18 international authors). She lives with her wife and cat, swims in the sea, and drinks way too much tea.