Sex After Hysterectomy

A hysterectomy is a surgical procedure to remove the uterus. It is commonly recommended to treat a variety of conditions such as uterine fibroids, endometriosis and many female cancers. Depending on the patient’s condition, a hysterectomy may involve the removal of surrounding organs or tissues as well, such as the cervix, fallopian tubes, and ovaries. Sometimes a portion of the vagina is also removed.

Sex after a hysterectomy is an important concern for many who decide to undergo the procedure. While such concern is warranted, several studies have reported that sexual pleasure and function remain largely unchanged following complete recovery from a hysterectomy. Other studies have also found that the procedure may even improve the quality of a person’s sex life by relieving the pain caused by their health condition.

However, it is important to consider several factors before resuming sexual activity following a hysterectomy. This article outlines some of these primary concerns.

If surgery only involved the removal of your uterus, your libido or sexual desire should remain largely unchanged following the procedure. However, this is dependent on individual patient factors such as your age and whether you are pre or post-menopausal. For pre-menopausal patients, you may notice a change in your desire to have sex if the surgery involved the removal of your ovaries as well.

Our ovaries produce estrogen, a hormone that stimulates vaginal lubrication and enhances sexual desire. Therefore, removing the ovaries may result in vaginal dryness and decreased sexual desire. However, you may choose to undergo hormone replacement therapy (HRT) following surgery. This will restore a fraction of the estrogen lost in the process. Furthermore, most women who undergo HRT after a hysterectomy report no change in libido. There are certain medical conditions where HRT is not recommended. Consult your healthcare provider to understand if HRT would be safe for your situation.

In most cases, you may choose to engage in non-penetrative sexual stimulation after a hysterectomy as soon as you feel ready to do so. However, you should wait for at least four to six weeks to allow the top of the vagina to heal before you can engage in penetrative sex. If your surgery was particularly intricate, your doctor may even recommend that you wait longer than six weeks.

Listen to your body

You may have passed the six-week mark following surgery or been given the green light from your doctor to engage in sex after your hysterectomy. However, it is important to only do so once you feel like your body is truly ready. Take as much time as necessary to ease back into having sex. You may also consider beginning with non-penetrative sex involving oral or manual stimulation, before easing into penetrative sex. It is also important to pay attention to warning signs such as severe pain or bleeding. Should you notice any of these, please consult your healthcare provider promptly.

Communicate openly with your partner

Be honest with your partner about any concerns or desires you may have regarding sex after a hysterectomy. Experiment with different positions until you find something that is comfortable. Let them know if something feels good or painful. Consider seeing a sex therapist or counselor if you are having trouble communicating openly with your partner during sex.

Use lubricant

You may experience vaginal dryness following a hysterectomy, particularly if the procedure involved the removal of one or both of your ovaries as well. In such cases, a water or silicone-based lubricant may be important to improving the quality of your sex life. If vaginal dryness persists, ask your healthcare provider about vaginal estrogen. This can be administered as a cream, ring or tablet that can be inserted into the vagina.

If you still have trouble with sexual desire, orgasm or discomfort during sex following a hysterectomy, don’t ignore it. Seek advice that is specific to your situation from your healthcare provider.