Female Sexuality Facts

Facts, Theories, And Information on Female Sexuality: Menstruation

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Menstruation - continued

Irregular Menstruation

Many women do not have absolutely regular periods each cycle. Counting from the first day of one period to the first day of the next, the menstrual flow may begin anytime between the 26th day and the 35th.

Unless the menstrual flow is accompanied by extraordinary bleeding or unusual pain, irregularity is not a medical problem. Irregular periods are especially common just after puberty and just prior to menopause. Another kind of irregularity, which is also common, is missing the occasional period altogether.

Almost every woman misses some periods in the course of her life and it is no cause for alarm, as long as it does not signal an unwanted pregnancy.

Unusual stress or illness can cause women to miss a period or two; the usual cycle returns once the difficulty has passed. Women who are regularly missing a period - several times a year - should have a medical check up.

Premenstrual Tension

Often known as PMS. Several days to a week before their period is to begin, many women notice a tenderness in their breasts, bloating or fluid retention, and some fatigue and irritability. Premenstrual tensions are real and obviously connected with bodily physical and chemical changes, possibly complicated by cultural factors as well.

Amenorrhea

When a woman does not have a period (even one) after she has reached puberty she has primary amenorrhea. If she stops having her period after having a history of menstruation she has secondary amenorrhea.

Amenorrhea may be due to hormonal imbalance, specific disease of the brain, ovaries or pituitary gland, extensive drug use or emotional stress. It also occurs of course when a woman is pregnant, but then it is normal and not a problem. Amenorrhea requires a complete medical evaluation.

Hysterectomy

This is the surgical removal of the uterus or womb. The surgery is done in one of two ways: either the uterus is removed through an incision in the abdominal area below the navel, or it is taken out through the vagina.

If the cervix is removed along with the rest of the uterus, a complete hysterectomy has been performed. If only the upper part is removed, and the cervix remains, it is a partial hysterectomy.

A hysterectomy is performed when there is definite evidence of disease or disorder that cannot be cured except by cutting out the womb. For example: when there is cancer of the cervix or cancer of the lining (endometrium) of the uterus; when abnormal tissue growths (fibroids) in the uterus interfere with normal function; when there is excessive uterine bleeding that does not respond to treatment; or when disease of the ovaries or Fallopian tubes also affects the uterus.

With the uterus removed two events are certain: the woman is sterile - she can no longer have a child - and she will no longer have her menstrual flow.

After a hysterectomy, the ovaries, which continue to produce hormones and ova, and the Fallopian tubes are still attached to structures in the pelvic area as before, so they can't flop around. The ova or eggs, which continue to be released until menopause, simply break down naturally, causing no pain or unusual sensations.

There was recently serious controversy over the use of hysterectomy as an immediate way to remedy problems that possibly could respond to other nonsurgical methods of treatment.

It is already the most common operation among women - 20 to 25 percent of women over the age of 50 have had it done. The projection currently is that one half of all women now under 65 will have had a hysterectomy by the time they reach that age.

Yet studies suggest that between 20 and 40 percent of hysterectomies performed in the U.S.A. are unnecessary or very questionable. Other countries - the U.K. for example - have much lower hysterectomy rates. Hysterectomy as the only known remedy for obvious uterine disease is difficult enough for the woman concerned.

But women who have had hysterectomies without having had severe uterine disease are referred to or seek psychological help or counseling help twice as frequently.

Hysterectomy as preventive medicine appears to set up serious personality conflicts. Several medical opinions should be sought and alternative treatments considered before any woman agrees to have a hysterectomy.

Q. "Is a hysterectomy like a D&C?"

A: "No. A hysterectomy is the surgical removal of the uterus. A D&C is the spreading of the cervix (dilation), and the gentle scraping of the uterine tissue (curettage), and is a procedure that used to be used to diagnose and treat specific disorders of the uterus. Tissue from the uterus is removed by D&C and examined for indications of cancer, polyps, infertility problems, abnormal uterine bleeding and other associated difficulties.

D&C has never been used as an alternative to hysterectomy, but it has been used as an early (during the first three months) abortion method. In this procedure, the tissue of the fetus is removed from the walls of the uterus by the curette, a metal loop on the end of a long thin handle. D&C has now been largely replaced by vacuum aspiration."

Q: "Don't your hormones stop after a hysterectomy? A friend told me she got menopause after her operation."

A: "No. Your hormones do not stop after a hysterectomy. Remember, hormones are produced and released mainly by the ovaries, and the ovaries are not removed in a hysterectomy.

Generally, only the uterus, or the uterus and cervix, are removed in a hysterectomy, and they do not produce or control hormones. It sounds like your friend had her ovaries removed in a procedure called oopharectomy.

This surgery is performed when there is a major disease (like cancer) of the ovaries. When both ovaries are removed the woman no longer receives the major portion of her natural supply of the hormone estrogen.

Although other glands, like the adrenals, try to help out, the total amount of estrogen decreases, and this often produces some of the symptoms of menopause. In cases where both ovaries are removed, the degree to which early menopause symptoms appear varies widely from woman to woman.

The physical and mental well-being of the woman play an important, not yet fully understood role in these situations, making it very difficult to generalize about what is likely to occur after surgery of this kind. In order to deal with the anticipated or actual menopausal symptoms that may occur after removal of both ovaries, some physicians prescribe regular doses of estrogen in pill form (known as ERT - Estrogen Replacement Therapy).

The Fallopian tubes remain where they always were because they are attached to other body structures. Rapid ejaculation training - in other words, some system for overcoming premature ejaculation, such as the one you can find here (click here) - can help you satisfy your partner more.

Q. "What happens to your sex life after a hysterectomy?"

A: "Sexual interest and drive, and the ability to have orgasm, are not affected by hysterectomy. In fact, it is likely that sexual pleasure and response may increase after hysterectomy, since a source of ill health has been removed, which may result in a sense of sexual reawakening.

It is reasonable to assume if sexual intercourse and other lovemaking was happy and pleasant before hysterectomy, the same kind of enjoyment and pleasure should continue afterward. Also, since the vagina is not seriously affected by the hysterectomy, there should be no concern or fear about the male penis hurting the vagina or internal organs. The physical sensations during intercourse remain the same for both the man and the woman.

When sexual problems occur after the operation, it is very likely that they existed before surgery, so the cause is usually in the relationship, and not in the surgery.

Sometimes, sexual problems that are emotional in origin can occur after a hysterectomy. Not being able to have a child may make a woman feel she is no longer complete and her interest in, and responsiveness to, sexual activity may be affected by this feeling of incompleteness and loss of self-esteem.

Following a hysterectomy, a male partner may have similar negative feelings about his wife or lover. Obviously, these feelings affect the relationship generally and sexual behavior specifically, and they need to be worked through by the couple themselves or, more likely, with the help of a qualified person."

Hysterectomy Myths

Hysterectomy includes removal of the ovaries. Not so, only the uterus. Removal of the ovaries is called oophorectomy and is done only when there is disease of the ovaries.

Hysterectomy results in advanced aging. False. Aging is aging, and the removal of the uterus does not stimulate the aging process.

Hysterectomy interferes with a woman's sex life. False. Sexual interest, sexual desire, sexual response and sexual pleasure are not affected by hysterectomy. just the reverse may be true, as many women report increased sexual interest when accidental pregnancy and menstruation are no longer possible.

Hysterectomy masculinizes a woman. False. Just because the uterus is removed a woman does not lose her feminine qualities.

Mild depression is common after a hysterectomy, but in most cases it soon disappears. Some women, however, find it difficult to regain their sense of self-worth. They doubt both their femininity and their ability to return to their life as it was before the operation. Stress with husband, children and friends may well result and may threaten family harmony.

Professional therapy is needed if these symptoms persist. It is clear that women who have had a hysterectomy as the way manage a uterine disease or disorder, and who have been completely informed about the procedure along with their husband or partner, show the best results emotionally, both in themselves and in their relationships.

Reflexology and Reiki can help with the menopause, as indeed can a variety of other complementary therapies such as aromatherapy, massage and counselling. Check out your personal health, both sexual and otherwise.

If a woman is involved in a relationship, it is important to the outcome of the treatment that her partner be involved from the outset in all discussions with physicians. A full understanding of the nature of the operation and of the short- and long-term results will enable the partner to provide more support and understanding; the evidence of that care and love can speed, or at least ease, recovery.

Many women feel that a hysterectomy strikes at the very core of their femininity.

Society has decreed that a woman's principal role is to bear children, and the loss of that ability can so damage her self-esteem that her relationships become difficult. Husbands, too, sometimes react negatively to their wives' loss of that potent symbol of womanhood.

Several studies suggest that husbands of women who have had a hysterectomy show evidence of emotional difficulty and are likely to seek professional help several years after the operation. This is especially true of the men who were not involved in the discussions and decision-making that preceded the surgery.