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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Old aged, undergone complete hysterectomy, interested in having good sexual relationship. Surgery done for vaginal prolapse. Suggestion?

Hi there I am a 69 year old woman, attractive, vivacious and deeply in love . I had a complete hysterectomy
about 25 years old. I am interested in having a good sexual relationship with this man . we have been
together for l4 months He has a strong libido but mine is not that good. climaxes are weak or delayed
I just had surgery for a vaginal prolaps and i feel young again in that respect. we are going on a honeymoon
cruise in jan. I would love tomake this a special occasion. Is there any help for this little lady?
Thu, 19 Sep 2013
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OBGYN 's  Response
Yes there is help for you. By complete hysterectomy, I'm assuming you mean that your ovaries were removed at age 25, which induces surgical menopause. You don't mention if you have been on hormone replacement therapy. If you have not, beginning estrogen for the first time at age 69 will increase your risk of heart disease and possibly breast cancer. However, there are other components to hormone replacement that can be safely initiated. I would evaluate your thyroid, adrenal and sex hormone levels and based on those results along with your history, initiate a balancing protocol of those hormone, minus the estrogen component. Libido in women is strongly affected by emotions and psychology, but there is a biochemical component operating as well. Specifically, your adrenal and testosterone levels are important in this context.
Pelvic prolapse repair reconstructs the anatomy of the vagina, which may be affected by vaginal birth and hysterectomy. However, the vaginal tissue may be thin and more rigid than in the past, especially if estrogen has not been used for the years since surgical menopause. Intravaginal estrogen may help heal the vaginal tissue so that sexual activity is more pleasurable from restoring the ability of the vagina to lubricate during sexual arousal. In addition, vaginal estrogen can help build up the vaginal mucosa and decrease the rigidity that may be present. The surgeon that performed your vaginal prolapse repair can help guide you regarding the risks of vaginal estrogen and whether or not that will increase the risks mentioned above with estrogen replacement. There is some estrogen absorption into the blood stream with vaginal estrogen therapy, but these levels can be monitored if you are willing to understand the risks.
For intercourse, a water based lubricant (such as AstroGlide) is essential for decreasing the frictional discomfort that may occur with thin vaginal mucosa.
Good luck! I hope this answers your questions. I am available for further consultation if needed.
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Recent questions on Vaginal prolapse


Old aged, undergone complete hysterectomy, interested in having good sexual relationship. Surgery done for vaginal prolapse. Suggestion?

Yes there is help for you. By complete hysterectomy, I m assuming you mean that your ovaries were removed at age 25, which induces surgical menopause. You don t mention if you have been on hormone replacement therapy. If you have not, beginning estrogen for the first time at age 69 will increase your risk of heart disease and possibly breast cancer. However, there are other components to hormone replacement that can be safely initiated. I would evaluate your thyroid, adrenal and sex hormone levels and based on those results along with your history, initiate a balancing protocol of those hormone, minus the estrogen component. Libido in women is strongly affected by emotions and psychology, but there is a biochemical component operating as well. Specifically, your adrenal and testosterone levels are important in this context. Pelvic prolapse repair reconstructs the anatomy of the vagina, which may be affected by vaginal birth and hysterectomy. However, the vaginal tissue may be thin and more rigid than in the past, especially if estrogen has not been used for the years since surgical menopause. Intravaginal estrogen may help heal the vaginal tissue so that sexual activity is more pleasurable from restoring the ability of the vagina to lubricate during sexual arousal. In addition, vaginal estrogen can help build up the vaginal mucosa and decrease the rigidity that may be present. The surgeon that performed your vaginal prolapse repair can help guide you regarding the risks of vaginal estrogen and whether or not that will increase the risks mentioned above with estrogen replacement. There is some estrogen absorption into the blood stream with vaginal estrogen therapy, but these levels can be monitored if you are willing to understand the risks. For intercourse, a water based lubricant (such as AstroGlide) is essential for decreasing the frictional discomfort that may occur with thin vaginal mucosa. Good luck! I hope this answers your questions. I am available for further consultation if needed.