When a lady has a complete hysterectomy, is it normal for her to gain a lot of weight? And is it normal to lose interest in sex? I love my husband, but I feel like I'm not what he wants now.

M.M.

Weight gain is common as we get older, and since most women who have hysterectomies are in their 40s and 50s, it is mainly coincidence that a few pounds appear after the surgery. There can be some minor weight gain due to decreased activity for several weeks as one recuperates, but this should resolve once one gets back into one's normal exercise habits.

As for the lack of interest in sex, that can indeed be for hormonal reasons. If ovaries were removed, there is a drop in testosterone as well as estrogen. Some women need a small amount of testosterone replacement to rev up their sex drive. Sometimes, if the ovaries were left but have stopped functioning (that is, if one is in menopause), just starting estrogen can improve sexual desire.

Another reason for a drop in libido can be problems with self-image. Some women feel as if they are less than a complete woman after having a hysterectomy. They may mourn the loss of their uterus, They may not feel as feminine and sexy. This is a harder problem to fix and may require seeing a therapist.

As a first step, mention your lack of sex drive to your gynecologist. If inadequate hormone levels seem to be the culprit, appropriate replacement may do the trick. If psychological and self-image issues are behind the lack of interest in sex, your doctor may be able to recommend a good therapist to help you improve your view of yourself.