Guest post by I. E. who lives in the Intermountain West with her husband, two children, and one cat who rules them all.

This is awkward—I don’t usually talk about my sex life on the internet or with almost anyone I know in person, either. But with the encouragement of a friend, I decided to write something for this series about menopause because too many stories about sex and orgasm after surgical menopause can only be described as scary, scary, scary.

This is only my experience. Everyone’s experience with sex and orgasm is individual and unique to their own body, partner(s), circumstances, and more. Your experience may be different, and that is okay. None of this is meant as medical advice and you should discuss your own health with your doctor and listen to your own body.

In 2019, I had a radical hysterectomy, or the removal of my cervix, uterus, fallopian tubes, and both ovaries. I was 37 years old and had been suffering from what my doctor suspected was adenomyosis for years. You may have heard about endometriosis before, where endometrial tissue grows outside the uterus. With adenomyosis, endometrial tissue grows inside the walls of the uterus. It generally leads to painful, heavy, long periods that include large blood clots. Adenomyosis usually cannot be definitively diagnosed until the tissue analysis after a hysterectomy, which is also the disorder’s only cure. I’d tried a number of birth control options to control the bleeding between pregnancies, but because I wanted to maintain my fertility, I wasn’t ready for a permanent solution until I was sure I was done having kids. When our youngest turned three, my husband and I felt confident our family was complete.

It was time to address the pain and bleeding that dominated my time and drained my energy every month. Treating adenomyosis does not require the removal of the ovaries, but because of a family history of ovarian cancer, I decided to have it all removed. That meant. . . surgical menopause! I didn’t want to worry about ovarian cancer in the future, but I was so scared about what surgical menopause and the loss of my uterus would do to my sexual function.

Some of my doctors and the medical websites I read said that this surgery may actually improve my sex life because I wouldn’t be dealing with menstrual cramp pain and heavy bleeding every month. But so many of the individual experiences I read told a different story. Many women said they lost their libido for months or years until the right balance of hormone replacement therapy brought it back. Some women experienced the ability to get aroused, but after surgery, could rarely if ever achieve orgasm. Some experienced complications like vaginal atrophy, severe vaginal dryness, or vaginal prolapse that made intercourse difficult or painful. Some women found the right treatments to address the problems, but others said their sexual function never got back to what they had before or what they wanted it to be.

I was scared. I didn’t want to lose my libido. I didn’t want to lose my ability to orgasm. I didn’t want to lose that physical intimacy in my marriage. Surgical menopause felt like jumping off a cliff into dark waters and I didn’t know what I would find below.

Part of preparing for surgery meant talking about my fears with both my therapist and my husband. That was uncomfortable. My husband and I would talk (and sometimes argue) about sex over the years. We’d talk about what we liked and didn’t like, what we wanted to try, how frequently we wanted to have sex. But I hadn’t ever talked to a therapist about sex with my husband. Talking to her helped me recognize my anxieties, name them, and prepare to talk to my husband about what I was afraid of losing. These conversations helped him be sensitive to my concerns and my worries about my body and about our sexual relationship. My husband assured me that he was walking this road with me and would be by my side through every change. We would figure it out together.

We were both raised LDS and had navigated the guilt and shame around masturbation in our youth, and it had taken many years for us to decide together that we were okay with occasional masturbation being an accepted and welcome part of our marital sex life. I wanted time to heal after surgery without feeling any need to rush back into sex before I was ready. I wanted my husband to feel confident that I was okay with him taking care of his own sexual needs in the time that I could not without guilt or shame. This may not be the right choice for every couple, but this felt like a healthy option for both of us.

When surgery came, there were physical restrictions as part of my recovery. I wasn’t supposed to lift anything over 10 lbs for at least six weeks. I wasn’t supposed to have any vaginal intercourse for even longer because of the delicate internal healing of the vagina. I started estrogen patches right away to hopefully avoid the worst menopause symptoms, and I think that helped. The first several days after surgery meant a lot of pain and mostly staying in bed, but as the days and weeks continued, my recovery went well. And it was a relief to not have the monthly pain and extreme bleeding every month. For that reason alone, I was very glad to have had the surgery. And then there was a welcome surprise.

I had worried so much about my sexual function before my surgery, but it wasn’t long after the surgery before I started feeling sexual desire again. It was far too soon for vaginal intercourse, but I wanted sex. My libido was still there! My desire felt. . . normal. Or rather, it felt like my own normal, and similar to how I felt before surgery. I wasn’t sure if orgasms would feel different, and I wanted to try without any pressure to perform for my partner. So when I felt ready, I used my vibrator for external stimulation. It’s hard for me to say if it was exactly the same as before, but what I know is that it felt good. I was still able to achieve orgasm.

When my husband and I began having sex together after my surgery, the first several months included only external stimulation. It turns out, paying that much extra attention to my clitoris during sex was not a bad thing. Whether through oral sex, vibrators, or external touch, it worked. My desire was there and my ability to orgasm was, too. When I was healed enough to try vaginal intercourse, we were sure to use our preferred lubricant, and it went well. The only difference I could notice from before my surgery was that we had improved our foreplay.

There are things that I still worry about with surgical menopause. I’ve had to adjust my hormone dosage a couple of times. I worry about the increased risk of osteoporosis and heart disease, so my workouts now include both more cardio and more weight lifting. I know some women undergo a radical hysterectomy and do not have as smooth of an experience as I did. Those stories are valid. But I wish that when going into surgery, I had a stronger balance of stories. I wanted to know the challenges and things to watch out and prepare for, but it would have been nice to have more stories about when it turns out okay.

I am 40 years old now and am three years post-menopausal because of my surgery. My doctor’s prediction was correct for me—without the monthly pain of adenomyosis, in some ways, my sex life is better than it was before surgery. And because of the conversations we had before my surgery, my husband and I are better than we were before about talking about sex and desire and differences in our sex drive.

I was afraid of the unknown going into surgery, but surgical menopause at age 37 did not mean the end of my sex life.

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If you are experiencing sexual dysfunction related to menopause or surgical menopause, there are options that may help. One of the best books I’ve encountered is The Menopause Manifesto by Dr. Jenn Gunter. She covers many topics, and only a little is about surgical menopause specifically, but even reading it a couple of years after my surgery, I got some helpful information to consider and adjusted one of my medications after talking to my doctor.

This post is part of the series Menopause and Me.