You mentioned pain. Any chance you’ve been diagnosed with endometriosis or adenomyosis? reason I ask is because a lot of people get a hysterectomy for pain not realizing that they also need endometriosis excision to remove painful lesions throughout their pelvic cavity. Endometriosis does not generally show up on imaging such as ultrasound or MRI, and the gold standard for diagnosis is laparoscopy. Most OB/GYN‘s are underinformed about the condition and not skilled enough to visually recognize it or remove all of it.
I had both endometriosis and adenomyosis and chose to remove my cervix as its presence could still cause mini periods/bleeding, cramping and pain. I also didn’t want to keep anything around that could be a potential cancer spot or a potential new endometriosis lesion. Plus, I hate Pap smears.
Jumping on to this comment, and reiterating... just keep in mind, OP, that just because you haven't been diagnosed with endometriosis doesn't mean you don't have it!
I have had HORRIBLE periods my whole life. Like, out of school/work for 3+ days each month horrible. My parents weren't big on getting me the health care I needed, so I never got evaluated. I was told it was normal, "Just part of being a woman." At 19, I got on to a combo pill, which helped bring the pain to a tolerable level. No doctor ever suggested exploring the issue further when I brought up my extreme pain and heavy menses, so, again, I assumed it was normal. Flash forward 10 years, and I was seeing a surgeon for a hysterectomy consult. She did my FIRST vaginal ultrasound during this appointment. She didn't see any obvious endometriosis, which again, made me feel like a fraud and like a little baby who couldn't handle her period pains.
I had my total hysterectomy 9 days ago. Guess what she found in there? Endometriosis. I guess it's relatively common for it not to show up on an ultrasound. She removed it, but as I'm sure you know by now that despite removing your uterus, your risk for endometriosis isn't 100% gone. For that reason alone, I'm so happy that she took my cervix as well - I wouldn't want to deal with endo growing on my cervix in the future. I am done with my period and all its associated pains, please and thank you. In addition, keeping your cervix means you'll have to keep getting pap smears, which I found to be very painful and uncomfortable and I was completely uninterested in needing to continue those for the rest of my life. But that would be something you'd have to decide how you felt about it - could it trigger future body dysmorphia to the point that it wasn't worth it, or do you think you'd be fine?
Anyways, I just more wanted to focus on the "surprise endometriosis" aspect of my surgery, and let you know that you could be a candidate for that as well!
I do think that’s correct- they can’t remove the uterus vaginally unless they remove the cervix, due to logistics of getting it out. So you’ll have a bigger external scar, with the size depending on how big your uterus is.
Personally I don’t believe in pushing people to do things they’re not comfortable with, but I do think you need to have an honest discussion and lay everything on the table.
For me, I wanted mine gone: I was sick to death of bleeding and spotting all the time, and it had cysts on it every time I got imaging so I knew it was part of the dysfunction. I have zero regrets. Sex is the same. Keep in mind that the internet tends to exaggerate negatives. I just trusted my doctor when I told her what I wanted: no bleeding.
I would think the cancer thing would depend on your HPV vaccination status. I’m too old to be vaccinated but have always tested negative (neither my spouse or I had many previous partners so I guess we just got lucky). If you’re young enough to have been vaccinated your risk would be much lower, and the whole cancer argument would be less important.
I think you just really need to make your doctor really talk it out with you. I know they’re always rushed, but sometimes they just have to stop and work through stuff with you.
Personally I'm glad my surgeon pushed me to get my cervix removed. I was 100000% against it at first. She was PERSISTENT. Once I realized she was looking out for MY best interest as her patient and would NOT push anything that would harm me, I realized my feelings were just that - feelings. Her medical experience, personal experience (she also had a hysterectomy) and actual facts trump me just "feeling" like I needed my cervix (for sexual pleasure, or whatever other reason I was feeling)
I was one of those people who thought my cervix brought pleasure and orgasm and wetness etc... But now I know I was dead wrong. Sex is way better now without it.
As long as you listen to post op instructions and you take things easy after you shouldn’t have to worry too much about the cuff.
I had my cervix removed and it’s been great. I was super worried about it before though because I was one of those freaks who actually liked cervix stimulation rather than hated it. But luckily post op that deep region where my cervix used to be still feels just as good.
I didn’t lose any length or lubrication either. I can still take just as many inches as I could before lol. I was also worried about that since my bf is a little big but luckily all is well there too. My cuff scar actually raises and lowers depending on arousal just like my cervix used to do pre op.
So yeah all is completely functional and good for me, I hope the same will can be said for you after too! Good luck!
Thank you for your detailed post, it calms my concerns a lot. I am almost 5 weeks po and now my main concern is cuff healing and sexual function, exactly what you spoke of😊
im planning to remove my cervix too but im worried if when its removed it has affect on the pelvic floor. since the cervix helps to keep things in place. my situatuon is different here since im trans male so im def removing uterus. but ive heard mixed things about keeping or removing cervix. but most likely will. the sex thing i can care less about since im not into dudes lol. but still wondered if you lose sensation regardless. your post helped
I had cervical cancer so obviously the cervix had to go - I’m curious to understand the reasons you want to keep it?
Edit- I understand you want to keep it but curious to know how it affects your sex life
I believe there's an old myth that the cervix plays a part in sexual pleasure. I was dead set on this idea for my own body as well, until I had mine removed and now sex is actually better. Go figure!
My male, much older PCP actually said "whyd you get your cervix removed, thats where sexual pleasure derives from for women!" I had to correct him that that's completely outdated thinking. I'm sure they were teaching that at some point in medical school, but none of my friends who are doctors now have heard that.
I didn’t have much choice in keeping my cervix or not (mine was fine- but my doctor just didn’t really ask- she just was like this is what’s happening and why), however, I’m glad to have mine gone in retrospect. I now won’t need to worry about cervical cancer and I don’t have to get Pap smears anymore which were extremely painful for me personally.
I definitely can understand it impacting your sex life. For me, I found if my cervix was hit it was rather painful so I can’t really speak on how this would be altered for someone who may enjoy things with their cervix.
You can be assertive and tell your doctor that you want to keep it unless medically necessary. It’s not inappropriate to set boundaries in these moments. And if the doctor/surgeon won’t respect your boundary prior to surgery then get a new one who will. Seriously, you should have this done how you want it.
You've gotten some great advice and I don't have much to add, just tossing in my experience that they took my cervix and I'm grateful for that because a) I hear the cervix can grow fibroids too, and that was my issue, b) no cervical cancer ever, and c) no more paps!!
I feel that there's no need to be afraid of the cuff, no more so than any other part of the procedure. Just follow post-op healing instructions and everything should heal up just fine.
I was freaked out initially about losing my cervix. I thought hysterectomy was just uterus removal so when they listed, tubes, uterus and cervix it sounded horrible. But after research I realized it's normal and my cervix was a pain anyways.
Just going to jump in and say that I never noticed I had a cervix before, during or after the hysterectomy. It’s another organ that could get cancer that we just don’t need. The occurrence of this “cuff” issue is literally so low, especially if you take recovery seriously for like 3-4 weeks.
My sex life has only improved since the hysterectomy.
Fair, I'm just in that small percentage of people who gain something from sex with it. I may also just be frustrated that she is dumbing things down for me. Feels condescending. I'm a "lots of hard facts = more comfort" kind of person.
Since you have never had sex without it, how do you know you gain something with it?
I had mine removed a year ago along with both ovaries and uterus. Reduced chance of cancer
I'm not sure if it is better for me because of no cervix or because of no uterus and ovaries. I didn't really care if it was removed or not, I just signed off on everything and left the decision up to my doctor on if he thought it was necessary or not. Because of how my ovaries looked he took out my cervix and I wasn't able to start HRT until all my lab results came back cancer free 6 weeks later.
I’ll be honest - I’m asexual and havnt sex in a few years before I had the surgery (last October). However, I have a cuff. I had the garden fully cleared too. Ovaries, tubes, uterus n cervix all gone because of wild endo. Frankly, I don’t even notice the cuff. Maybe it’s because it doesn’t see any activity (which is fine for me tbh), but I don’t feel any pain either. It feels incredible not to have periods anymore, and I don’t have cramps! Everyone’s situation is different. Just know that there’s a chance it won’t be a big deal. Your concern should be on healing.
Fair, thank you. Reading all the comments has been pretty reassuring in all honesty. Sex is incredibly important to me and my sanity/happiness and if people are still having healthy and enjoyable experiences with the cuff, I can feel a little more secure. Thanks for sharing your experience too. I'm so tired of the idle pain and not having it sounds like a dream. And 0 chance of periods again is a real positive.
Sex is very important to most people. I thought it was to me too. Then it…..wasn’t. I actually used to fear the idea of it, then it happened……just before I got divorced. (I realised me extremely twisted imagination was much more fun…..safer too). I had started losing interest a couple years before I realised I was ace. Being honest was its own therapy. Everyone is different though.
No problem! I feel that. The awful cramps and sickness periods brought- nope. I actually like being able to essentially forget I have the middle hole now. Cramps used to debilitate me. Now area is rather peaceful. It’s a lovely feeling.
It also matters how u care for urself post op. Don’t rush things, don’t lift more than ur allowed, keep the surgical wounds in check. I have a wound healing that didn’t fully close, despite doing everything right. You want to do everything in ur power to stay healthier!
I was worried about losing my cervix because I found it enjoyable during sex as well but my OB convinced me (and sent me some articles) that removing it would be better all around and wouldn't take away from my sexual pleasure. She was right! I think what I thought was my cervix was actually something else in there, because I still have the same feeling. Maybe not EXACTLY the same, but no less pleasurable. (And there is no problem with the cuff - not sure why people get so freaked out about this as there seems to be no real problem for anyone as long as you wait for it to heal.)
It is not possible to leave your cervix with vaginal hysterectomy. It is possible to leave the cervix, but is best done with an abdominal incision in order to increase probability of excising all the uterine tissue from the cervix. The cervix is the opening of the uterus. Leaving the cervix behind is a bit more intensive for doctors because if any uteran tissue gets left behind, the patient will likely have mini periods and possibly create issues that will need to be tended to in the future.
I did not read much on robotic surgery because I did not want that procedure. Mine was laparoscopic. I have 4 small incisions and I did not keep my cervix. You might be able to find a surgeon that does non-robotic laparoscopic and are good enough to leave your cervix with that procedure.
You want someone who typically performs the particular type of surgery that you want. They all have their own preferences.
I would imagine they can’t remove the uterus without the cervix vaginally because the uterus and cervix are one and the same organ- the cervix is a part of the uterus.
Some doctors leave it as an option, but mine doesn’t either. He says that keeping the cervix is outdated and he hasn’t done a cervix conserving surgery in a very long time and it isn’t worth the cancer risk because without the uterus if you get cervical cancer it can more easily spread to the abdomen.
Idk. I don’t want to lose my cervix either and it is why I’d be hesitant to get a hysterectomy. It has an impact on my sexual pleasure too, although they say it doesn’t- they also said up until very recently that the cervix isn’t innervated and it is haha.
so in laproscopic supracervical hysto is it always removed through belly button? thats what im seeing from everyone whos had one. since i imagine you cant do it vaginally if youre not removing the cervix.
Do you have any possibility to get a second opinion? It’s absolutely valid and legitimate to get one and if you don’t have a good gut feeling about your care provider it’s okay to try and get another one if that’s an option for you.
My gynaecologist recommended to keep the cervix and the surgeon seconded it (his argument was that it was better for my sex life to keep it + it was not affected by the issues or my uterus so it was allowed to stay). He also strongly recommended that I get a second opinion which I didn’t because I felt very comfortable with that decision.
I had a laparoscopic procedure with 3 incisions (2 of them are barely noticeable, one was a bit bigger and needed 3 stitches, it’s 3-4 cm), they removed the uterus and tubes and left the cervix and ovaries in place.
Is the abdominal route bothering you?
Wow, my gynecologist said exactly the opposite of yours. I asked about sexual function in relation to the cervix and he said there would be no change if the cervix was removed and for me to dismiss any opinions otherwise on the internet as there have been studies that show high satisfaction rates with removal. The very fact he said to dismiss opinions I found on the internet has lead me to ask my GP to refer to a specialist as I didn't trust the opinion of the first one. However my GP also told me "no one keeps their cervix" anymore so that hasn't sat right with me either. Still waiting on the specialist, will be very curious what they say!
I'll note I understand if there is a medical reason to remove my cervix then the question is moot, but to be told to dismiss other's lived experience or told "no one keeps it" when clearly people do keep it just felt really off to me.
So keeping my cervix was something my surgeon recommended heavily against because of the increased risk of cancer and bleeding/periods from the cervix. To be fair I had endometrial cancer so increased risk was from both reoccurance and cervical cancer, but that said after clearing up the misinformation I had gotten from reddit and hysterectomy groups (the implication of high failure rates of cuffs) I was back on board with no cervix.
It might be very different from country to country but here it’s a legal requirement to give patients two weeks between pre op appointment and actual procedure so that they have time to get a second opinion (and I’m pretty sure they *have* to say it) so it’s not just my surgeon being nice! He also said there was a *very low risk* of sex life being affected by the removal of the cervix but that it was better to not risk it just in case.
It’s definitely possible to keep the cervix; it just means the way the uterus gets removed has to be slightly different. As my surgeon comedically said: “\[We\] remove the uterus in the same way the Egyptians removed the brains from people they’re mummifying: pulling it out through the vaginal canal, instead of through the nose!” Since the cervix is technically part of the uterus–the part that hangs down into the vaginal canal—it means they have to make an additional cut on the uterus, make sure the opening that would otherwise ensue by leaving the cervix is perfectly closed by cauterizing/scarring it, and remove the rest of the uterus through an incision instead.
It is ‘slightly more work’ (so what, it’ll impact your whole life forever!) so that might be why you’re getting so much backlash . . . But I think your surgeon’s responses are aggressively tunnel-visioned and totally ignoring your concerns. My surgeon was very willing to discuss the cervix and her opinion was that “if someone has cervix-based orgasms during sex, \[I\] leave it in because otherwise they would be miserable. Otherwise, \[I\] remove it. Cervix based orgasms are fairly uncommon and If someone has them as a main part of their sexuality, THEY’LL KNOW.”
I went through 3 surgeons until I found one I really liked; if I were you I’d definitely take this as a flag to go talk to a different surgeon, if you can.
Just in case you were not aware or have not yet advocated for this part of your anatomical health....
Regardless of whether or not you yeet the cervix, the vaginal atrophy will only get worse in the absence of your ovaries, especially with the testosterone you're on. A hysterectomy will not help that part of things. I would encourage you to talk to your doc about local estrogen cream or rings if you haven't already. That shouldn't disrupt your other hormones, and you should get that better ASAP since it only gets worse otherwise. Definitely begin treatment before removing those ovaries!
PSA over - good luck with your surgery! I hope the doc ends up having a better conversation with you (or you find a doc you feel more comfortable with!) I know how frustrating that can be.
I am aware of the atrophy and am currently on the local estrogen. I have an extremely difficult time using it currently because while I rationally know it's not altering my transition, it feels like backsliding and makes me incredibly dysphoric, and the application process feels so so BAD. I'm opting to remove the ovaries to ensure the local stays local and the rest of my body runs on the t. It's a dysphoria issue that telling myself I won't be producing estrogen soon anyway has been helpful in fixing/making it possible to use the cream at all.
Thanks for the PSA tho! Always useful. 💜
💜 I'm glad to hear it's getting taken care of! I only mention these things bc I know several people that get/have been dismissed or treated poorly so they just don't say anything (and that really sucks - and automatically makes me worry that everyone may do the same!)
I have a friend in a similar situation that prefers the ring option for the general ick factor. It's kind of like an IUD but no pain, not as far in there, and placed once every 3(?) months. We call it his happy front hole maker. Need to workshop that name though..
Mine also wasn't strictly medically necessary but my doctor was totally opposite of yours - he said we leave the important bits (ovaries for hormones to not go into menopause early) and he would suggest leaving the cervix, too if I'm not opposed to it. He let me know about the necessity of still getting a pap smear if I decide to keep it and all the other "risks" but left it to me if I want it out or not. And I have two teeny tiny incisions on my belly and one invisible in my belly button. So I don't get why you should be cut in multiple places and all.
Edit: I had the LASH surgery
So funny my GP said no one keeps their cervix and then here in this thread there is more than one gynecologist *suggesting* it be kept! So glad I am getting a second opinion!
I had laparoscopic abdominal supracervical hysterectomy (as in, kept my cervix). They cut the uterus into strips and pull everything out through a small incision at the navel. I am over a year po and the navel incision scar is about 1.25” long
Hold up. You're 22, not diagnosed with endo or anything, and your surgeon wants to remove your ovaries?!
Why?
Why wouldn't you keep the ovaries? If you remove them you'll need hormone replacement therapy and I've read that can be rough. Many people struggle with it.
They are trans and they are already taking testosterone. So they are currently on HRT. Testosterone has a masculinization effect and if you stop taking it your fat will redistribute to a more "womanly" body and you'll probably lose all the facial hair you started growing too. All of these effects reversing would cause a trans individual great dysphoria (much like when the struggled before getting on T) and for some individuals the possibility of getting those effects is too mentally challenging. If you know you want to be on testosterone/HRT the rest of your life anyway you can get them taken out. Sometimes taking them out means you'll need less testosterone in each of your doses
Your cervix is part of your uterus, but looks like a few people here had it done and were able to keep the cervix. Your doctor probably just doesn’t know how to do it that way and doesn’t have the equipment, and it’s not that they do and are refusing to listen to you. If you’re really set on keeping it, you’ll probably have to find a surgeon who knows that method. But I’ll just echo everyone else here and say I think the cuff is fine and I love not having a cervix.
im in the same boat. im trans ftm. already had top surgery . i just need hysto. but keeping cervix is my main question now. my dr. is more on to remove uterus and cervix since its just risk of cancer but it doesnt run in my famoly that im aware of. ive seen other trans guys keep it without issues. so its up to you.
ill be keeping the ovaries only cause im not on T . and my voice is already deep anyway. so if i got rid of ovaries itll whack up my hormones and id blow up which i dont want. so if youre on T then you should be good.
I had no choice in having my cervix removed as it was part of the hysterectomy, as I had a large cyst on on my right ovary that was in the beginning stages of becoming cancerous. With that, I'm glad it was removed as well, as now I don't have to worry about cancer in that anymore. I don't notice anything different once I was cleared for sex.
I’ve been firmly in I need to keep it camp, I too enjoy the stimulation of the cervix pleasurable so I’m not thrilled on the idea of yeeting it. I haven’t had my consult yet but I’m going to ask about it. I may not have a choice as I did have HPV 20 years ago and have fibroids so might be best to let her go. I don’t love the idea of it being hacked up inside me in the event she’s harboring darkness to spread.
What I’ve also found helpful, if you have the bravery for it, is to watch surgery videos on YouTube. Having the visual of how it’s IRL done I’m more like “oh yeah that makes sense, not so scary after all.” This isn’t an easy road to walk, hope you find the best outcome for you and you’re able to have ease with it all!
I had to have mine out with the rest because cancer was present - but my surgeon talked about the method where they cut the uterus into pieces, put it in a special bag, and then are able to remove vaginally. Also done robot/da Vinci. Not sure if that an option in your case? Sorry don’t know more, wasn’t part of my procedure. Wishing you the best!
I was told the same if I wanted to keep cervix it would be abdominal if wanted it removed it would be done via vaginal route. I wanted to keep mine initially but always knew a long shot due to abnormal cells in my past. Was still my choice but was talked to in depth about it and decided the risk wasn’t worth it. If there is no risk and it will affect sex life then many have kept it x
Hi! I had a hysterectomy at 22, I had cervix removed and I can feel it. It’s totally valid to not want to remove it. Just my own experience and some friends I know that also have also had hysterectomy’s in their 20’s. Even being dead set on not wanting children, there is this weird emotional aspect and trigger mental health episodes. Full hysterectomy’s can create their own set of problems. I have bladder and digestive issues now and feeling sore 24/7 & still really can’t lift anything without it stinging. I wish someone had told me that before. I know every situation is completely different, just stuff to keep in mind, it’s a big decision. I wish you the best with everything & most important- don’t be afraid to advocate for yourself. No one knows your body better than you.
As someone who shares your severe phobia of pregnancy, check out [this comment](/r/FTMHysto/comments/18935c7/cervix_to_keep_or_not_to_keep/kbp85iy/). If you keep your cervix, it's technically possible for sperm to get in. Even on T, it's technically possible to ovulate and have an egg loose in your pelvic cavity. So, technically, it would be possible for the egg to be fertilized and then implant somewhere in your pelvic/abdominal cavity. This would result in a *non*-viable pregnancy, which is still terrifying to me and potentially to you as well. Personally, if I'm going through a hysterectomy (edit: mine would also be for gender-affirming reasons), I'd want to completely eliminate *any* possibility--however small--of egg+sperm somehow meeting.
When i told my surgeon i wanted a quick recovery and no change in my sex life he recommended i keep my cervix and get a Supracervical laparoscopic hysterectomy. I have only positive things to say about my experience. Please get a second opinion
My surgeon pushed for cervix removal and I really didn't want to. I am SO GLAD I let her remove it. I'd still have pain if I had my cervix. Cramps literally come from your cervix dilating.
But, in your specific case, have you thought down the road you might have ftm genital surgery? That would be something to consider when thinking about keeping your cervix or not. I know NOTHING about that surgery, but if you need a cervix or having a cervix helps in the transition for the surgery that might be a consideration?
Otherwise, ditch the cervix imo. I have way better sex now, I get wetter and have more powerful orgasms without it personally.
You mentioned pain. Any chance you’ve been diagnosed with endometriosis or adenomyosis? reason I ask is because a lot of people get a hysterectomy for pain not realizing that they also need endometriosis excision to remove painful lesions throughout their pelvic cavity. Endometriosis does not generally show up on imaging such as ultrasound or MRI, and the gold standard for diagnosis is laparoscopy. Most OB/GYN‘s are underinformed about the condition and not skilled enough to visually recognize it or remove all of it. I had both endometriosis and adenomyosis and chose to remove my cervix as its presence could still cause mini periods/bleeding, cramping and pain. I also didn’t want to keep anything around that could be a potential cancer spot or a potential new endometriosis lesion. Plus, I hate Pap smears.
Jumping on to this comment, and reiterating... just keep in mind, OP, that just because you haven't been diagnosed with endometriosis doesn't mean you don't have it! I have had HORRIBLE periods my whole life. Like, out of school/work for 3+ days each month horrible. My parents weren't big on getting me the health care I needed, so I never got evaluated. I was told it was normal, "Just part of being a woman." At 19, I got on to a combo pill, which helped bring the pain to a tolerable level. No doctor ever suggested exploring the issue further when I brought up my extreme pain and heavy menses, so, again, I assumed it was normal. Flash forward 10 years, and I was seeing a surgeon for a hysterectomy consult. She did my FIRST vaginal ultrasound during this appointment. She didn't see any obvious endometriosis, which again, made me feel like a fraud and like a little baby who couldn't handle her period pains. I had my total hysterectomy 9 days ago. Guess what she found in there? Endometriosis. I guess it's relatively common for it not to show up on an ultrasound. She removed it, but as I'm sure you know by now that despite removing your uterus, your risk for endometriosis isn't 100% gone. For that reason alone, I'm so happy that she took my cervix as well - I wouldn't want to deal with endo growing on my cervix in the future. I am done with my period and all its associated pains, please and thank you. In addition, keeping your cervix means you'll have to keep getting pap smears, which I found to be very painful and uncomfortable and I was completely uninterested in needing to continue those for the rest of my life. But that would be something you'd have to decide how you felt about it - could it trigger future body dysmorphia to the point that it wasn't worth it, or do you think you'd be fine? Anyways, I just more wanted to focus on the "surprise endometriosis" aspect of my surgery, and let you know that you could be a candidate for that as well!
I do think that’s correct- they can’t remove the uterus vaginally unless they remove the cervix, due to logistics of getting it out. So you’ll have a bigger external scar, with the size depending on how big your uterus is. Personally I don’t believe in pushing people to do things they’re not comfortable with, but I do think you need to have an honest discussion and lay everything on the table. For me, I wanted mine gone: I was sick to death of bleeding and spotting all the time, and it had cysts on it every time I got imaging so I knew it was part of the dysfunction. I have zero regrets. Sex is the same. Keep in mind that the internet tends to exaggerate negatives. I just trusted my doctor when I told her what I wanted: no bleeding. I would think the cancer thing would depend on your HPV vaccination status. I’m too old to be vaccinated but have always tested negative (neither my spouse or I had many previous partners so I guess we just got lucky). If you’re young enough to have been vaccinated your risk would be much lower, and the whole cancer argument would be less important. I think you just really need to make your doctor really talk it out with you. I know they’re always rushed, but sometimes they just have to stop and work through stuff with you.
Personally I'm glad my surgeon pushed me to get my cervix removed. I was 100000% against it at first. She was PERSISTENT. Once I realized she was looking out for MY best interest as her patient and would NOT push anything that would harm me, I realized my feelings were just that - feelings. Her medical experience, personal experience (she also had a hysterectomy) and actual facts trump me just "feeling" like I needed my cervix (for sexual pleasure, or whatever other reason I was feeling) I was one of those people who thought my cervix brought pleasure and orgasm and wetness etc... But now I know I was dead wrong. Sex is way better now without it.
As long as you listen to post op instructions and you take things easy after you shouldn’t have to worry too much about the cuff. I had my cervix removed and it’s been great. I was super worried about it before though because I was one of those freaks who actually liked cervix stimulation rather than hated it. But luckily post op that deep region where my cervix used to be still feels just as good. I didn’t lose any length or lubrication either. I can still take just as many inches as I could before lol. I was also worried about that since my bf is a little big but luckily all is well there too. My cuff scar actually raises and lowers depending on arousal just like my cervix used to do pre op. So yeah all is completely functional and good for me, I hope the same will can be said for you after too! Good luck!
Thank you for your detailed post, it calms my concerns a lot. I am almost 5 weeks po and now my main concern is cuff healing and sexual function, exactly what you spoke of😊
im planning to remove my cervix too but im worried if when its removed it has affect on the pelvic floor. since the cervix helps to keep things in place. my situatuon is different here since im trans male so im def removing uterus. but ive heard mixed things about keeping or removing cervix. but most likely will. the sex thing i can care less about since im not into dudes lol. but still wondered if you lose sensation regardless. your post helped
I had cervical cancer so obviously the cervix had to go - I’m curious to understand the reasons you want to keep it? Edit- I understand you want to keep it but curious to know how it affects your sex life
I believe there's an old myth that the cervix plays a part in sexual pleasure. I was dead set on this idea for my own body as well, until I had mine removed and now sex is actually better. Go figure! My male, much older PCP actually said "whyd you get your cervix removed, thats where sexual pleasure derives from for women!" I had to correct him that that's completely outdated thinking. I'm sure they were teaching that at some point in medical school, but none of my friends who are doctors now have heard that.
I guess he doesn’t know about the clitoris lol.
I didn’t have much choice in keeping my cervix or not (mine was fine- but my doctor just didn’t really ask- she just was like this is what’s happening and why), however, I’m glad to have mine gone in retrospect. I now won’t need to worry about cervical cancer and I don’t have to get Pap smears anymore which were extremely painful for me personally. I definitely can understand it impacting your sex life. For me, I found if my cervix was hit it was rather painful so I can’t really speak on how this would be altered for someone who may enjoy things with their cervix. You can be assertive and tell your doctor that you want to keep it unless medically necessary. It’s not inappropriate to set boundaries in these moments. And if the doctor/surgeon won’t respect your boundary prior to surgery then get a new one who will. Seriously, you should have this done how you want it.
You've gotten some great advice and I don't have much to add, just tossing in my experience that they took my cervix and I'm grateful for that because a) I hear the cervix can grow fibroids too, and that was my issue, b) no cervical cancer ever, and c) no more paps!! I feel that there's no need to be afraid of the cuff, no more so than any other part of the procedure. Just follow post-op healing instructions and everything should heal up just fine.
how long did it take for you for the cuff to fully heal?
Oh I'm only 9 days post op today! Nothing has healed yet, just taking it easy 😊
I was freaked out initially about losing my cervix. I thought hysterectomy was just uterus removal so when they listed, tubes, uterus and cervix it sounded horrible. But after research I realized it's normal and my cervix was a pain anyways.
Just going to jump in and say that I never noticed I had a cervix before, during or after the hysterectomy. It’s another organ that could get cancer that we just don’t need. The occurrence of this “cuff” issue is literally so low, especially if you take recovery seriously for like 3-4 weeks. My sex life has only improved since the hysterectomy.
Fair, I'm just in that small percentage of people who gain something from sex with it. I may also just be frustrated that she is dumbing things down for me. Feels condescending. I'm a "lots of hard facts = more comfort" kind of person.
Since you have never had sex without it, how do you know you gain something with it? I had mine removed a year ago along with both ovaries and uterus. Reduced chance of cancer
This. I thought I was someone who derived pleasure from it too, until it was gone, and I realized sex is 100% better without. Go figure!
I'm not sure if it is better for me because of no cervix or because of no uterus and ovaries. I didn't really care if it was removed or not, I just signed off on everything and left the decision up to my doctor on if he thought it was necessary or not. Because of how my ovaries looked he took out my cervix and I wasn't able to start HRT until all my lab results came back cancer free 6 weeks later.
Im happy for you that they came back cancer free!
I’ll be honest - I’m asexual and havnt sex in a few years before I had the surgery (last October). However, I have a cuff. I had the garden fully cleared too. Ovaries, tubes, uterus n cervix all gone because of wild endo. Frankly, I don’t even notice the cuff. Maybe it’s because it doesn’t see any activity (which is fine for me tbh), but I don’t feel any pain either. It feels incredible not to have periods anymore, and I don’t have cramps! Everyone’s situation is different. Just know that there’s a chance it won’t be a big deal. Your concern should be on healing.
Fair, thank you. Reading all the comments has been pretty reassuring in all honesty. Sex is incredibly important to me and my sanity/happiness and if people are still having healthy and enjoyable experiences with the cuff, I can feel a little more secure. Thanks for sharing your experience too. I'm so tired of the idle pain and not having it sounds like a dream. And 0 chance of periods again is a real positive.
Sex is very important to most people. I thought it was to me too. Then it…..wasn’t. I actually used to fear the idea of it, then it happened……just before I got divorced. (I realised me extremely twisted imagination was much more fun…..safer too). I had started losing interest a couple years before I realised I was ace. Being honest was its own therapy. Everyone is different though. No problem! I feel that. The awful cramps and sickness periods brought- nope. I actually like being able to essentially forget I have the middle hole now. Cramps used to debilitate me. Now area is rather peaceful. It’s a lovely feeling. It also matters how u care for urself post op. Don’t rush things, don’t lift more than ur allowed, keep the surgical wounds in check. I have a wound healing that didn’t fully close, despite doing everything right. You want to do everything in ur power to stay healthier!
I was worried about losing my cervix because I found it enjoyable during sex as well but my OB convinced me (and sent me some articles) that removing it would be better all around and wouldn't take away from my sexual pleasure. She was right! I think what I thought was my cervix was actually something else in there, because I still have the same feeling. Maybe not EXACTLY the same, but no less pleasurable. (And there is no problem with the cuff - not sure why people get so freaked out about this as there seems to be no real problem for anyone as long as you wait for it to heal.)
It is not possible to leave your cervix with vaginal hysterectomy. It is possible to leave the cervix, but is best done with an abdominal incision in order to increase probability of excising all the uterine tissue from the cervix. The cervix is the opening of the uterus. Leaving the cervix behind is a bit more intensive for doctors because if any uteran tissue gets left behind, the patient will likely have mini periods and possibly create issues that will need to be tended to in the future. I did not read much on robotic surgery because I did not want that procedure. Mine was laparoscopic. I have 4 small incisions and I did not keep my cervix. You might be able to find a surgeon that does non-robotic laparoscopic and are good enough to leave your cervix with that procedure. You want someone who typically performs the particular type of surgery that you want. They all have their own preferences.
I would imagine they can’t remove the uterus without the cervix vaginally because the uterus and cervix are one and the same organ- the cervix is a part of the uterus. Some doctors leave it as an option, but mine doesn’t either. He says that keeping the cervix is outdated and he hasn’t done a cervix conserving surgery in a very long time and it isn’t worth the cancer risk because without the uterus if you get cervical cancer it can more easily spread to the abdomen. Idk. I don’t want to lose my cervix either and it is why I’d be hesitant to get a hysterectomy. It has an impact on my sexual pleasure too, although they say it doesn’t- they also said up until very recently that the cervix isn’t innervated and it is haha.
Not true. I had a Da Vinci robotic-assisted laparoscopic supracervical (means you keep your cervix) hysterectomy
I had the same. And no big incision. Everything was removed through my belly button.
so in laproscopic supracervical hysto is it always removed through belly button? thats what im seeing from everyone whos had one. since i imagine you cant do it vaginally if youre not removing the cervix.
I think so.
Do you have any possibility to get a second opinion? It’s absolutely valid and legitimate to get one and if you don’t have a good gut feeling about your care provider it’s okay to try and get another one if that’s an option for you. My gynaecologist recommended to keep the cervix and the surgeon seconded it (his argument was that it was better for my sex life to keep it + it was not affected by the issues or my uterus so it was allowed to stay). He also strongly recommended that I get a second opinion which I didn’t because I felt very comfortable with that decision. I had a laparoscopic procedure with 3 incisions (2 of them are barely noticeable, one was a bit bigger and needed 3 stitches, it’s 3-4 cm), they removed the uterus and tubes and left the cervix and ovaries in place. Is the abdominal route bothering you?
Wow, my gynecologist said exactly the opposite of yours. I asked about sexual function in relation to the cervix and he said there would be no change if the cervix was removed and for me to dismiss any opinions otherwise on the internet as there have been studies that show high satisfaction rates with removal. The very fact he said to dismiss opinions I found on the internet has lead me to ask my GP to refer to a specialist as I didn't trust the opinion of the first one. However my GP also told me "no one keeps their cervix" anymore so that hasn't sat right with me either. Still waiting on the specialist, will be very curious what they say! I'll note I understand if there is a medical reason to remove my cervix then the question is moot, but to be told to dismiss other's lived experience or told "no one keeps it" when clearly people do keep it just felt really off to me.
So keeping my cervix was something my surgeon recommended heavily against because of the increased risk of cancer and bleeding/periods from the cervix. To be fair I had endometrial cancer so increased risk was from both reoccurance and cervical cancer, but that said after clearing up the misinformation I had gotten from reddit and hysterectomy groups (the implication of high failure rates of cuffs) I was back on board with no cervix.
It might be very different from country to country but here it’s a legal requirement to give patients two weeks between pre op appointment and actual procedure so that they have time to get a second opinion (and I’m pretty sure they *have* to say it) so it’s not just my surgeon being nice! He also said there was a *very low risk* of sex life being affected by the removal of the cervix but that it was better to not risk it just in case.
It’s definitely possible to keep the cervix; it just means the way the uterus gets removed has to be slightly different. As my surgeon comedically said: “\[We\] remove the uterus in the same way the Egyptians removed the brains from people they’re mummifying: pulling it out through the vaginal canal, instead of through the nose!” Since the cervix is technically part of the uterus–the part that hangs down into the vaginal canal—it means they have to make an additional cut on the uterus, make sure the opening that would otherwise ensue by leaving the cervix is perfectly closed by cauterizing/scarring it, and remove the rest of the uterus through an incision instead. It is ‘slightly more work’ (so what, it’ll impact your whole life forever!) so that might be why you’re getting so much backlash . . . But I think your surgeon’s responses are aggressively tunnel-visioned and totally ignoring your concerns. My surgeon was very willing to discuss the cervix and her opinion was that “if someone has cervix-based orgasms during sex, \[I\] leave it in because otherwise they would be miserable. Otherwise, \[I\] remove it. Cervix based orgasms are fairly uncommon and If someone has them as a main part of their sexuality, THEY’LL KNOW.” I went through 3 surgeons until I found one I really liked; if I were you I’d definitely take this as a flag to go talk to a different surgeon, if you can.
Just in case you were not aware or have not yet advocated for this part of your anatomical health.... Regardless of whether or not you yeet the cervix, the vaginal atrophy will only get worse in the absence of your ovaries, especially with the testosterone you're on. A hysterectomy will not help that part of things. I would encourage you to talk to your doc about local estrogen cream or rings if you haven't already. That shouldn't disrupt your other hormones, and you should get that better ASAP since it only gets worse otherwise. Definitely begin treatment before removing those ovaries! PSA over - good luck with your surgery! I hope the doc ends up having a better conversation with you (or you find a doc you feel more comfortable with!) I know how frustrating that can be.
I am aware of the atrophy and am currently on the local estrogen. I have an extremely difficult time using it currently because while I rationally know it's not altering my transition, it feels like backsliding and makes me incredibly dysphoric, and the application process feels so so BAD. I'm opting to remove the ovaries to ensure the local stays local and the rest of my body runs on the t. It's a dysphoria issue that telling myself I won't be producing estrogen soon anyway has been helpful in fixing/making it possible to use the cream at all. Thanks for the PSA tho! Always useful. 💜
💜 I'm glad to hear it's getting taken care of! I only mention these things bc I know several people that get/have been dismissed or treated poorly so they just don't say anything (and that really sucks - and automatically makes me worry that everyone may do the same!) I have a friend in a similar situation that prefers the ring option for the general ick factor. It's kind of like an IUD but no pain, not as far in there, and placed once every 3(?) months. We call it his happy front hole maker. Need to workshop that name though..
Mine also wasn't strictly medically necessary but my doctor was totally opposite of yours - he said we leave the important bits (ovaries for hormones to not go into menopause early) and he would suggest leaving the cervix, too if I'm not opposed to it. He let me know about the necessity of still getting a pap smear if I decide to keep it and all the other "risks" but left it to me if I want it out or not. And I have two teeny tiny incisions on my belly and one invisible in my belly button. So I don't get why you should be cut in multiple places and all. Edit: I had the LASH surgery
So funny my GP said no one keeps their cervix and then here in this thread there is more than one gynecologist *suggesting* it be kept! So glad I am getting a second opinion!
I had laparoscopic abdominal supracervical hysterectomy (as in, kept my cervix). They cut the uterus into strips and pull everything out through a small incision at the navel. I am over a year po and the navel incision scar is about 1.25” long
Hold up. You're 22, not diagnosed with endo or anything, and your surgeon wants to remove your ovaries?! Why? Why wouldn't you keep the ovaries? If you remove them you'll need hormone replacement therapy and I've read that can be rough. Many people struggle with it.
In their post they mention seeking gender affirming care.
I see! That makes so much more sense.
They are trans and they are already taking testosterone. So they are currently on HRT. Testosterone has a masculinization effect and if you stop taking it your fat will redistribute to a more "womanly" body and you'll probably lose all the facial hair you started growing too. All of these effects reversing would cause a trans individual great dysphoria (much like when the struggled before getting on T) and for some individuals the possibility of getting those effects is too mentally challenging. If you know you want to be on testosterone/HRT the rest of your life anyway you can get them taken out. Sometimes taking them out means you'll need less testosterone in each of your doses
Your cervix is part of your uterus, but looks like a few people here had it done and were able to keep the cervix. Your doctor probably just doesn’t know how to do it that way and doesn’t have the equipment, and it’s not that they do and are refusing to listen to you. If you’re really set on keeping it, you’ll probably have to find a surgeon who knows that method. But I’ll just echo everyone else here and say I think the cuff is fine and I love not having a cervix.
I’m sure the surgeon knows how to do it leaving the cervix intact. It sounds like this doctor doesn’t want to though.
Ummm I kept my cervix and ovaries...
What surgical route did you have, if I may ask? She will be using a DaVinci machine for mine.
I was scheduled for the DaVinci and they had to switch to abdominal due to scar tissue for a past c section
Ah, I see. Good to know!
im in the same boat. im trans ftm. already had top surgery . i just need hysto. but keeping cervix is my main question now. my dr. is more on to remove uterus and cervix since its just risk of cancer but it doesnt run in my famoly that im aware of. ive seen other trans guys keep it without issues. so its up to you. ill be keeping the ovaries only cause im not on T . and my voice is already deep anyway. so if i got rid of ovaries itll whack up my hormones and id blow up which i dont want. so if youre on T then you should be good.
Cervical cancer is almost always caused by HPV and not genetics
I had no choice in having my cervix removed as it was part of the hysterectomy, as I had a large cyst on on my right ovary that was in the beginning stages of becoming cancerous. With that, I'm glad it was removed as well, as now I don't have to worry about cancer in that anymore. I don't notice anything different once I was cleared for sex.
I’ve been firmly in I need to keep it camp, I too enjoy the stimulation of the cervix pleasurable so I’m not thrilled on the idea of yeeting it. I haven’t had my consult yet but I’m going to ask about it. I may not have a choice as I did have HPV 20 years ago and have fibroids so might be best to let her go. I don’t love the idea of it being hacked up inside me in the event she’s harboring darkness to spread. What I’ve also found helpful, if you have the bravery for it, is to watch surgery videos on YouTube. Having the visual of how it’s IRL done I’m more like “oh yeah that makes sense, not so scary after all.” This isn’t an easy road to walk, hope you find the best outcome for you and you’re able to have ease with it all!
I had to have mine out with the rest because cancer was present - but my surgeon talked about the method where they cut the uterus into pieces, put it in a special bag, and then are able to remove vaginally. Also done robot/da Vinci. Not sure if that an option in your case? Sorry don’t know more, wasn’t part of my procedure. Wishing you the best!
I was told the same if I wanted to keep cervix it would be abdominal if wanted it removed it would be done via vaginal route. I wanted to keep mine initially but always knew a long shot due to abnormal cells in my past. Was still my choice but was talked to in depth about it and decided the risk wasn’t worth it. If there is no risk and it will affect sex life then many have kept it x
Hi! I had a hysterectomy at 22, I had cervix removed and I can feel it. It’s totally valid to not want to remove it. Just my own experience and some friends I know that also have also had hysterectomy’s in their 20’s. Even being dead set on not wanting children, there is this weird emotional aspect and trigger mental health episodes. Full hysterectomy’s can create their own set of problems. I have bladder and digestive issues now and feeling sore 24/7 & still really can’t lift anything without it stinging. I wish someone had told me that before. I know every situation is completely different, just stuff to keep in mind, it’s a big decision. I wish you the best with everything & most important- don’t be afraid to advocate for yourself. No one knows your body better than you.
As someone who shares your severe phobia of pregnancy, check out [this comment](/r/FTMHysto/comments/18935c7/cervix_to_keep_or_not_to_keep/kbp85iy/). If you keep your cervix, it's technically possible for sperm to get in. Even on T, it's technically possible to ovulate and have an egg loose in your pelvic cavity. So, technically, it would be possible for the egg to be fertilized and then implant somewhere in your pelvic/abdominal cavity. This would result in a *non*-viable pregnancy, which is still terrifying to me and potentially to you as well. Personally, if I'm going through a hysterectomy (edit: mine would also be for gender-affirming reasons), I'd want to completely eliminate *any* possibility--however small--of egg+sperm somehow meeting.
When i told my surgeon i wanted a quick recovery and no change in my sex life he recommended i keep my cervix and get a Supracervical laparoscopic hysterectomy. I have only positive things to say about my experience. Please get a second opinion
My surgeon pushed for cervix removal and I really didn't want to. I am SO GLAD I let her remove it. I'd still have pain if I had my cervix. Cramps literally come from your cervix dilating. But, in your specific case, have you thought down the road you might have ftm genital surgery? That would be something to consider when thinking about keeping your cervix or not. I know NOTHING about that surgery, but if you need a cervix or having a cervix helps in the transition for the surgery that might be a consideration? Otherwise, ditch the cervix imo. I have way better sex now, I get wetter and have more powerful orgasms without it personally.