A University of Toronto researcher is calling renewed attention to a crucial but often overlooked aspect of women’s health: the impact of hysterectomy type on post-operative sexual wellbeing. Recent work suggests the decision between radical and simple hysterectomy—two procedures used primarily in the treatment of uterine and cervical cancers—has profound implications not only for cancer control but also for the long-term quality of life, including sexual health, for women worldwide, including those in Thailand.
Hysterectomy, or the surgical removal of the uterus, is a life-saving procedure for many facing gynecologic cancers or other serious conditions. However, as highlighted by University of Toronto’s Faculty of Medicine, the choice between a radical and simple hysterectomy matters far beyond the operating table. A radical hysterectomy involves removal of the uterus, the upper part of the vagina, and surrounding tissues, while a simple hysterectomy is more limited, usually only removing the uterus and cervix.
For Thai patients, where hysterectomy rates are steadily rising—Mirroring international trends according to a 2023 review in the International Journal of Gynecology & Obstetrics—this research raises timely questions about balancing survival with wellbeing. Post-operative sexual health is particularly sensitive, often affected by nerve damage, hormonal changes, vaginal length, and vaginal lubrication. According to the University of Toronto researcher, women undergoing radical hysterectomy frequently report more sexual dysfunction, including pain during intercourse (dyspareunia) and decreased desire. Conversely, a simpler procedure can sometimes preserve more sexual function, but may not always be advisable depending on the cancer’s extent.
“Too often, sexual health and psychological outcomes are not prioritized in surgical planning,” explains the University of Toronto research team. They emphasize that informed, shared decision-making is vital, particularly for younger women and those with early-stage disease who may have a choice between procedures. Experts such as the leading gynecologic oncologist at Chulalongkorn Hospital note that, in Thailand, open conversations about sexuality and post-surgical expectations are rare, partly because of cultural taboos and misinformation. “Many Thai women are unaware of the impact hysterectomy can have on their intimate relationships until after the procedure,” a senior advisor at the Thai Society of Gynecologic Oncology shared in a public health webinar last year.
This concern carries significant weight in Thai society, where traditional values may make discussions of sexual health particularly sensitive. Research published in the Journal of Obstetrics and Gynaecology Research has found that Thai women frequently experience anxiety and depressive symptoms after hysterectomy, with sexual dysfunction compounding these issues. The lack of targeted post-operative sexual health counseling in most Thai hospitals exacerbates the issue, often leaving women to seek answers from informal networks or remain silent about their concerns.
Thailand’s Ministry of Public Health has recognized the importance of comprehensive cancer care but has yet to issue detailed guidelines on addressing sexual health during gynecological cancer treatment. Emerging best practice internationally, however, highlights the benefits of pre- and post-operative counseling. Studies reveal that when women are equipped with realistic expectations and tools for sexual rehabilitation, they report higher satisfaction and emotional wellbeing post-surgery (BMJ Sexual & Reproductive Health).
Looking ahead, experts urge Thai clinicians and policymakers to do more to integrate sexual health into oncologic care. This could include routine use of sexual function questionnaires, culturally-sensitive patient education materials, and specialized training for healthcare providers. Hospitals in Bangkok and Chiang Mai are beginning to pilot holistic, multidisciplinary teams—including psychologists and sex therapists—to support cancer patients before and after hysterectomy.
For Thai women and their families, the message is clear: when facing hysterectomy decisions, it is essential to ask about not only cancer outcomes but also potential effects on sexual health. “Don’t be afraid to seek a second opinion, and ask your doctor about options that might preserve sexual function,” recommends a leading reproductive health advocate at the National Cancer Institute. “It’s your right to comprehensive information.”
With hundreds of Thai women undergoing hysterectomy each year, ensuring that sexual health becomes a standard part of pre-surgical discussions would mark a significant step forward—in both medical care and women’s rights. Those considering surgery are encouraged to speak candidly with their medical providers, seek out support groups (such as those affiliated with the Thai Cancer Society), and advocate for access to holistic information and care.
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