After a hysterectomy, this loss of motivation can occur suddenly right after surgery or within several years of surgery, when a woman finds she is no longer interested in sex.

Treatment is usually estrogen pills with injections of testosterone or a vaginal cream made of estrogen and testosterone. In the United States, a product known as ESTRATEST is widely available. It is a pill taken by mouth that contains both estrogen and testosterone. Side effects of testosterone include masculinizing effects such as facial hair, deepening of the voice and enlarged clitoris. These side effects may be mostly reversed if the dose is adjusted. The long-term side effects are unknown.

Vaginal lubrication usually tends to lessen after hysterectomy. Also if the vagina has been shortened, or scar tissue forms in the vagina or pelvis, painful sex may then result.

• You are safer because you no longer have to worry about uterine and/or ovarian cancer.

Deaths from uterine cancer are the same as deaths from unnecessary hysterectomies. There is no justification for routine hysterectomy for the prevention of uterine cancer.

Ovarian cancers occurs in one in 100 women over 40 with cure rates of only ten to 20 percent This is the reason that so many gynecologists recommend taking out the ovaries out as a preventative measure. However, the question is highly controversial and it is far from clear that risks of routine removal of the ovaries outweighs the benefits. It is estimated that two hundred normal ovaries have to be cut out to prevent one woman from getting ovarian cancer.

Some studies show that the actual risk for developing ovarian cancer after a hysterectomy with the ovaries left in place is very small, around one in a 1,000.

Furthermore, removal of the ovaries may necessitate taking hormone replacement with estrogen and progesterone for the rest of your life or facing bone loss, immediate menopause and increased likelihood of cardiac disease.

After menopause, the ovaries continue to secrete hormones for ten to 20 years later. Some of these hormones support the well-being and health of the older women and also protect against bone loss. Artificially administered hormones can never replace the complex interrelationships between the ovaries, uterus and brain, as yet imperfectly understood.

• Complication rates and recovery period after hysterectomy is the same as after other major surgery.

Hysterectomy is followed by two to three times the incidence of post-op depression compared to other elective surgery such as gallbladder surgery. Hysterectomy patients also have a much longer recovery period, an average of 11.9 months compared to three months for other types of surgery. Thus before you have a hysterectomy, you should arrange for extra help and plan to go easy on yourself for the 12 months following your hysterectomy. This recovery period may be dramatically shortened as laparoscopic hysterectomy becomes more available (see below).

The risk of dying from hysterectomy is very low, about one per thousand. In real numbers this adds up to 600 women per year in the U.S. dying from complications of hysterectomy, and 60 a year in Canada.

Forty to 50 percent of women have surgical complications following hysterectomy. These include post-op infections, urinary tract complications, and hemorrhage (more than one in ten woman will require a blood transfusion).

Other less common complications include damage to the bowels during surgery (2 percent of women with hysterectomies will later require further bowel surgery to remove scar tissues) blood clots, complications from anesthesia and formation of scar tissue in the abdomen.

Since the uterus holds many of the internal organs, Dr. Vicki Hufnagel has noted that after hysterectomy, other organs may cave in or collapse causing pelvic pain, sexual problems and pressure on bowel and bladder.

After hysterectomy, there is an increased incidence of urinary incontinence or the inability to hold your urine.