How To Have Sex After a Hysterectomy

You might not be surprised to hear that a hysterectomy is the second most common surgery for women, following a cesarean section. It seems to be so common that the side effects and recovery are often dismissed and leave many women without options for pain management or optimal recovery. At Pepper we want to empower you to navigate your sex life with confidence after this procedure by giving you everything you need to know about having sex after a hysterectomy. Thankfully there are many accessible ways to ensure your sex life not only survives, but thrives!

Can you still have sex after a hysterectomy?

YES! I hope that gave you a sigh of relief. One of the most frequently asked questions is how long after a hysterectomy can you have sex? There will be a recovery period following the procedure that is usually a minimum of 6 weeks before it is safe to resume sex. After this timeframe when tissue has been given a chance to heal, sex can resume. Sometimes after the recovery period sex may be painful or feel different than prior to surgery because your organs and ligaments have shifted, and scar tissue may have grown in ways that are not ideal for penetration or stimulation. Thankfully the body has an incredible capacity to change and heal with the right support. If you are still feeling pain or have bleeding more than 6 weeks after surgery, make sure to talk to your doctor. If your doctor rules out infection and/or issues with incision healing, then seeing a pelvic floor therapist is your next best step to help resolve these symptoms. Remember that every individual has a healing journey unique to them, and six weeks is simply a guideline. Listen to your body and do what feels right for you.

Does sex feel different after hysterectomy?

The average uterus weighs 4oz – this is a significant structure to remove! The uterus has many ligaments attached to surrounding structures and is sandwiched between the bladder and rectum. The organs and ligaments around the uterus will find a new position to rest, which can create new pressure sensations in the pelvic floor or lower abdomen after a hysterectomy. During sex, these new sensations may be heightened because of the pressure toward the lower abdomen where the uterus is removed. Sensations during sex after a hysterectomy are different for everyone. For some, this may actually increase pleasure, while others may experience pain. If the attaching nerves to the cervix are stretched or nicked during surgery, this can cause loss of sensation or altered orgasm following a hysterectomy. Finding a highly skilled surgeon with extensive experience in hysterectomy will lower your risk of complications. 

Are pain and bleeding normal during sex after a hysterectomy?

Bleeding after a hysterectomy typically lasts 1-3 weeks. If you continue to have vaginal bleeding, then you should consult with your doctor immediately. Pain and bleeding are never normal during sex, even one month after your hysterectomy. The most common reason you might experience this is from tight scar tissue that is tearing during penetration or stimulation. This tissue can be effectively stretched with dilators or dildos. Some great options that can be used for self-stretching are The Deia or La Wand Grand Bullet. Choosing a smaller option first will ensure you don’t have tearing with dildo use. Once a smaller option is comfortable, you can graduate to a wider circumference to continue lengthening your pelvic floor tissue. Measuring your partner and matching this to a dilator or dildo is a good way to create a measurable and controlled goal.

Best sex positions for after a hysterectomy.

As mentioned before, recovery is individualized. Following your intuition and checking in with how you feel during sex is key. You will likely experience different sensations or discomfort in positions that were previously pleasurable. Getting creative or having an open mind to new positions may sound exhausting after recovering from a surgery, but the benefits of finding a feel-good position far outweigh the alternative of pain or avoiding sex altogether. If you are feeling stumped with positions, try the Position of the Day book to find new positions with your partner. 

How to increase sex drive after a hysterectomy.

Most reports state that women return to their sex drive 3 months to 2 years after a hysterectomy. This can largely be influenced by removal of the ovaries during hysterectomy, which are important for sex hormone secretion. If ovaries are spared during the surgery, it is less likely you will experience a diminished sex drive. If you feel a low desire for sex after hysterectomy, try these quick tips to get your drive going:

1. Set the mood. 

Why not use some sensual massage oil to heat things up prior to penetration. Light a few candles around the room to heighten your senses and calm your nervous system if you had a busy day. Use The Intimacy Deck to connect with your partner and engage in erotic conversation. 

2. Foreplay. 

This should be a go-to part of your sex life for any experience between the sheets. The more warmed up your tissue is, the more pleasurable your climax will be. Engaging in foreplay will also elongate your sexual connection with your partner to make for an extra pleasurable time in bed.

3. Lube. 

We can all agree that having sex when the juices are flowing is so much better than the alternative… because, ouch! Nobody wants dry sex. You can peruse Pepper’s first-class lubricant selection and make sure to have a couple options tucked away in your bedside drawer.

4. Have your hormones checked. 

As mentioned above, if your ovaries were removed during your hysterectomy you will have a significant dip in circulating sex hormones that will surely affect your sex drive. Seeing a doctor for your hormone levels may render a hormone replacement prescription that can largely help with your libido.

5. Consider pain medication. 

This may be helpful during the acute healing phase up to 6 months following surgery and should be prescribed by your doctor if you are experiencing persistent pain or discomfort with intercourse that does not resolve with conservative methods. Pain medication prescribed by your doctor may also help take the edge off with scar tissue stretching using a dilator or dildo.

It is completely normal to have concerns after undergoing a hysterectomy but the bottom line is that your sex life can still thrive after this surgery. Use the resources above to help guide you through your healing process and regain desire and drive with your partner. If things feel complicated after surgery, remember there are resources through your doctor and pelvic floor therapist that can aid you in resolving unwanted symptoms. Most importantly, listen to your body.

Claire is a pelvic floor therapist with a distinct specialty certification in pelvic rehabilitation (PRPC). She is the private clinic owner of Rooted Pelvic Health & Hand Therapy in Sun Valley, Idaho. She treats all gender diversities for pelvic floor-related conditions including sexual dysfunction, gynecological cancer recovery, and chronic pelvic pain. Claire's mission is to improve overall function and quality of life with lasting results for her clients. As a contributing writer to Pepper Together, Claire seeks to provide education about a subject that deserves more attention. She hopes that by spreading the word about pelvic floor conditions she can break the stigma about conversations around sex, and provide simple solutions to improve sexual intimacy.