What to Expect With Sex After a Hysterectomy
Sex after a hysterectomy can bring up physical and emotional concerns. This blog by the Pelvic Awareness Project, a resource for women about pelvic health, offers gentle, practical tips for easing back into intimacy, understanding your body, and reclaiming pleasure at your own pace.
Can Women Have A Good Sex Life After A Hysterectomy?
There are plenty of questions that come to mind when you find out you need to have a hysterectomy.
Some concerns you may have will be about the surgery itself, such as how invasive it is and whether you will have a big scar. You may wonder how long one will be in the hospital for a hysterectomy. What is the recovery time for a hysterectomy?
Once you are reassured about your basic health concerns, you will also want to know what to expect with sex after a hysterectomy. An active and pleasurable sex life is part of your healthy lifestyle, so what happens after you have had surgery? Let’s explore sex after a hysterectomy.
Understanding Hysterectomy
Surgery known as a hysterectomy means the removal of your uterus, and most likely your cervix too. There are different types of hysterectomy, as it can include the removal of surrounding organs and tissues, like your fallopian tubes and ovaries.
The specific version of surgery is chosen depending on the reason for the removal of your uterus. Examples include abnormal bleeding, uterine prolapse, fibroids, and cancer. After a hysterectomy, the lack of a uterus means you won’t be able to get pregnant, and you won’t get your menstrual period.1
The Four Kinds Of Hysterectomy:1
- Total hysterectomy: Your uterus and cervix are removed but your ovaries are not. Because you still have your ovaries, you won’t enter menopause after surgery.
- Total hysterectomy with bilateral salpingo-oophorectomy: That’s a very long medical term for the removal of the uterus, cervix, fallopian tubes, and ovaries. The removal of your ovaries means you will start menopause immediately, if you haven’t already before surgery.
- Supracervical hysterectomy: Just the upper part of the uterus is removed, and the cervix is left intact. You may or may not have your fallopian tubes and ovaries removed, too.
- Radical hysterectomy with bilateral salpingo-oophorectomy: This is common when cancer is involved, because it involves the total removal of the uterus, cervix, fallopian tubes, ovaries, the upper portion of the vagina, and some surrounding tissue and lymph nodes.
Recovery From Hysterectomy
There are different forms of surgery for hysterectomy, too, which can impact the recovery time. For instance, with a vaginal hysterectomy, your uterus is removed through an incision at the top of your vagina. There are no incisions on the abdomen, recovery time is about four weeks, and women can typically go home the day of surgery.
A laparoscopic hysterectomy is a minimally invasive surgery completed with a small telescopic rod placed through a small incision. Patients may go home the same day or the next day. An abdominal hysterectomy requires a more extended hospital stay and a longer recovery time, as the uterus is removed through a six- to eight-inch incision in your abdomen.1
What to Expect With Sex After a Hysterectomy
Be sure to gather all the necessary information from your doctor before your surgery.
After surgery, your doctor should review your recovery process, including side effects like soreness at the incision site, and any vaginal bleeding or drainage. You’ll receive specific guidance on restrictions, such as no heavy lifting.
What about sex? What can you expect with sex after you have had a hysterectomy?
First off, you will be told not to have sex for six weeks after surgery, while your body recovers. After that, different women have different experiences with sex after a hysterectomy.
The Body Changes After a Hysterectomy
If a woman has her ovaries removed during a hysterectomy, she will experience surgical menopause. Since it happens immediately, the symptoms can be more sudden and intense than when a woman enters menopause naturally.
In terms of sex after a hysterectomy, the sudden lack of estrogen means women may suffer from vaginal dryness, discomfort, or itchiness, which could lead to painful intercourse.2 The lowered levels of hormones can also lead to a lowered sex drive.3
On the flipside, there could be positive changes to a woman's body that may enhance their sex life.
For instance, if a woman had a hysterectomy because she had heavy bleeding or pelvic pain, she might feel relief after surgery. Women may be able to better enjoy sex without the pain, bleeding, or other adverse side effects that led to the surgery. 4
Emotional Effects of Hysterectomy
Some women experience emotional side effects from a hysterectomy.
Some women may feel a sense of loss and grief at the loss of their uterus, realizing that they are unable to have children.4 If you’re feeling sad or depressed, see a healthcare provider. Use our Physician Finder tool to find a doctor near you with expertise in women’s health to help you with these feelings.
If the ovaries were not removed, some women could still have common PMS side effects, since their ovaries will still release eggs and make hormones. You won’t have menstrual bleeding without a uterus, and you won’t be able to get pregnant. So you should be aware of possible mood swings, bloating, and cramps that could impact your sex drive each month.5
For other women, there’s a sense of relief that they can’t get pregnant when they have sex. Some women say their sex lives actually improve, in part because they can’t get pregnant, and also because the symptoms that led to the hysterectomy have also been removed.
Without worrying about pelvic pain or bleeding, sex after a hysterectomy might be more enjoyable. Your sex drive may increase after that pain or discomfort is gone.5
One way for any woman to enhance the enjoyment of sex is by strengthening the pelvic floor muscles. Performing Kegel exercises can help alleviate pain and improve control during sex.6 That’s because the pelvic floor muscles play an important role in bodily functions, including sex. Read more about Kegel exercises and the important role they can play in pelvic health.
For many women, there will be no change in their experience of sex after a hysterectomy.4
Women's Experiences with a Hysterectomy
Every woman’s experience is different. Sex after a hysterectomy may not change at all for you, or it could be more pleasurable. See your doctor if you have concerns, so that you can enjoy a vibrant sex life after a hysterectomy. The pelvic floor can cause pain and other problems. See your doctor for diagnosis and treatment so that you can be on the road to good pelvic health.
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1- https://my.clevelandclinic.org/health/procedures/hysterectomy
2- https://my.clevelandclinic.org/health/diseases/22354-low-estrogen
3- https://pmc.ncbi.nlm.nih.gov/articles/PMC3956099
4- https://www.mayoclinic.org/tests-procedures/vaginal-hysterectomy/about/pac-20384541
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