Demolitive surgery on female reproductive system has a great impact on sexuality of the woman and of the couple. Consequences are often underestimated by the surgeon, while those may have a great value on surgery management, both emotionally and technically. Several women improve sexuality, above all when pre-existent disease affected their sexual activity, e.g. bleeding uterus. Other women have negative consequences; so that they suffer from a psychic syndrome like post-hysterectomy syndrome. Negative consequences are worse and more frequent after total mastectomy and vulvectomy. Surgery typology or some technical tricks may help women to preserve and, often, improve their sexuality, which should always be evaluated according to clinical parameters during the surgery planning. It is hoped a psychological training to the surgery in order to evaluate and manage the attitude and the expectations of women, or of couples, about this kind of surgery.