couldn’t, because you can’t just go in
and magically fix broken nerves.”
Still, the validation allowed her to do
something her years-long search for
answers never did: try to move on with
her life. Shortly after her trip to San
Diego, she contacted a sperm bank and,
in March of this year, found out she was
pregnant. She now smiles when she
talks about feeling her baby kick. It
feels, she says, like hope.When Dr. Irwin Goldstein
presents his theory at medical confer-
ences, it tends not to go well. “It’s shock-
ing how defensive the gynecological
community gets. They say, ‘I’ve never
s e e n t h i s. You’r e ma k i n g t h i s up.’ Ye t
there are entire groups of women
who’ve had LEEPs who have problems.”
Much of Dr. Goldstein’s research is
c on s ide r e d “c ont r ove r s i a l ,” s ay s T a mi
Rowen, MD, an ob-gyn at the Univer-
sity of California San Francisco Medi-
cal Center. Or as Dr. Andrew Goldstein
puts it: “Dying from cervical cancer
is horrific. We can write about how
the treatment affects orgasms or
we can write about how it saves mil-
lions of lives.” (He clarifies that he
doesn’t want to downplay the sexual
ramifications of LEEPs and that doc-
tors should not perform the procedure
“aggressively.”)
In the field of urology, doctors regu-
larly discuss the possible sexual side
effects of surgery on the male repro-
ductive organs—and Dr. Irwin Gold-
stein says this should happen in
gynecology too: “An era has to come
when we accept that there are risks to
operating on the cervix.”
Of course, doctors brushing off
women’s sexuality is nothing new. In
1978, the International Society for Sex-
ual Medicine was established...and
focused on men. Four years later, the
first nerve-sparing prostatectomy was
performed to treat prostate cancer
without causing permanent sexual
dysfunction. The groundbreaking
technique was possible thanks to
decades of research on the prostatedoctors and have them not believe
you,” she says.
It was five years after her LEEP that
a trauma therapist finally referred her
to Irwin Goldstein (no relation to
Andrew), MD, the director of San
Diego Sexual Medicine. By then,
Sasha’s life had fallen apart. She’d lost
touch with friends as they became
annoyed by her fixation on her cervix.
She’d still occasionally try hooking up
with people, but it was always unsatis-
factory, reinforcing her fears about the
brokenness of her body. She’d even
quit her job as an accessories designer,
too depressed to work. “I remember
spending a lot of money on vibrators
and lubricants,” she says. Sometimes,
mashing her clitoris like a button, she
could eke out a vague clitoral
orgasm—a tiny, disengaged fraction of
what she had experienced before.
But in Dr. Goldstein, Sasha finally
found someone who believed her.
After previous patients had com-
plained about LEEPs, he referenced a
pioneering 2004 study led by Rutgers
neuroscientist Barry Komisaruk,
PhD, to theorize that some LEEPs
cut too deeply into the cervix and
sever vital nerve endings, silencing
the genital connection to the brain.
Komisaruk now speculates this
could even have a numbing effect on
the entire area. Simply put: A too-
aggressive LEEP might scoop out a
woman’s cancer risk—but also some
or all of her sexual feeling.
“Nobody teaches doctors or does
quality control on how deep to go,”
says Dr. Goldstein. “There is no appre-
ciation for the three very important
nerves in the cervix...and that the
deeper you go, the higher your chance
of denervating the whole thing.”
He ran tests, including using a
device to place increasing pressure
against Sasha’s cervix—she could
b a r e ly fe e l it. T h i s c on f i r me d , he t old
her, that her nerves had been dam-
aged by her LEEP. She was overcome
with bittersweet relief. “I wanted him
to fix me,” she says, “and I knew he
and penis, says Arthur Burnett, MD, a
urologist at Johns Hopkins Medicine.
Similar research on women has
lagged way behind, says James
Simon, MD, president of the Interna-
tional Society for the Study of Wom-
en’s Sexual Health. This means
women often report experiencing sex-
ual symptoms years or even decades
b e for e t he y s how up i n me d ic a l j ou r -
nals. (Dr. Rowen uses the example of
the birth-control pill, whose sexual
side effects were once routinely dis-
missed by doctors.) Like Sasha, they
f i nd t he ms e lve s c au g ht i n t he a gon i z -
ing gap between their experience and
published science.
Dr. Irwin Goldstein and Komisaruk
are trying to remedy this, collaborat-
ing with a team that is dissecting
cervixes removed during hysterecto-
mies to determine the exact location
of those nerves. They hope to help
gynecologists perform more precise
LEEPs in the future.
In the meantime, some doctors are
exploring other options. Dr. Rowen
hasn’t had patients complain about
sex after a LEEP, but she routinely
uses cryotherapy instead, since it’s
similarly effective at slashing cancer
risk without cutting into the cervix.
“If people believe LEEPs cause sexual
dysfunction—and I think there’s evi-
dence to show it does—women should
at least be told there’s a risk,” she says.For women already left
sexually damaged, the search for
orgasm continues. Emily still can’t
have sex on top without pain.
Michelle, 36, who had satisfying sex
nearly every day before her LEEP,
now says, “I just have to enjoy every-
thing that goes along with sex, like
satisfying my partner, and not be
upset that I can’t orgasm. Because it’s
just not going to happen.”
When she complained to her doctor,
he suggested she switch the birth con-
trol she’s been on for several years.
After her new insurance kicks in, she
plans to see a new gyno.142 Cosmopolitan October 2019
This routine gyno procedure could mean you never orgasm again C o n t in u e d f r o m p a g e 131