Having a hysterectomy can feel like a life-changing event — mentally and physically. And, on some level, you’re right — significant changes happen to your body, which can cause some discomfort. Life is full of phases, and being “postmenopausal” is just one more of them to journey through.
Painful sex after a hysterectomy is one of the most common complaints we hear. But you don’t have to relegate yourself to a life of uncomfortable, unsatisfying sex.
We’re here to help you keep that bed rocking and the orgasms flowing — you don’t need a uterus to have fun, after all!
What Does a Hysterectomy Entail?
Having surgery can be intimidating — sometimes, knowing what’s going to happen can help relieve some of that anxiety. We’ll talk briefly about the process of having a hysterectomy and its recovery, but feel free to skip ahead if you’re not the type of person who benefits from this sort of discussion (we’re not judging!).
Even though the surgical procedure has improved by leaps and bounds in the past several decades — most of them are now done laparoscopically (done through small incisions using a camera) — a hysterectomy is still a major surgery and should be treated as such. However, it’s also the second most common surgery that people with a uterus have annually in the United States.
Your doctor will surgically remove your uterus during a hysterectomy, which is done under general anesthesia (so you won’t be awake or remember any of the procedure). The procedure usually takes no more than an hour.
Depending on why you are having the hysterectomy performed, your doctor may also elect to remove one or both of your ovaries (an oophorectomy). If your uterus, ovaries, and fallopian tubes are removed, this is a total hysterectomy.
The timeline for your recovery will be individual, depending on your pre-existing health conditions and the type of hysterectomy you undergo. You should expect to spend at least one night in the hospital (potentially longer if you had an open or vaginal hysterectomy).
The most common complaint immediately after having a hysterectomy is pain, especially for the first few days. You may also experience constipation, which is often related to pain medication.
Full recovery from a hysterectomy usually takes six to eight weeks but can vary depending on what type of hysterectomy you have (more extensive surgeries where more is removed usually take longer to heal from).
However, during your recovery period, it’s crucial not to stay too stationary. While you shouldn’t be running marathons, getting up and moving around is helpful in reducing the risk of post-surgical blood clots (according to ACOG — the American College of Obstetricians and Gynecologists).
It’s also strongly urged to keep anything out of the vagina for the first six weeks after your procedure — tampons, douche, fingers, sex toys, a penis, etc. If you do experience any bleeding after your hysterectomy (which is common), you can use menstrual pads. This is to reduce the risk of infection or injury as you heal.
Why Does Sex Hurt After a Hysterectomy?
As we said, a hysterectomy is a major surgery. Just like it takes time for your body to heal and recover after the procedure is over, it can also take time for it to adjust to its new situation.
Painful sex after a hysterectomy can be related to a few factors — most associated with changing hormones. These hormones are responsible for ensuring the delicate vaginal tissues have enough blood flow to keep them oxygenated and working properly so that they don’t become thin or tear easily.
However, in most cases, a hysterectomy doesn’t impact the ability of sex to feel good. In rare circumstances, where the cervix is removed, or there is damage to the pelvic floor muscles, there may be some change in sensation. Otherwise, once you find out how to adjust after your surgical procedure, you should be able to enjoy sex just as much as you did before.
If you do experience painful sex after a hysterectomy, we strongly recommend that you schedule an appointment with your gynecologist. It could be a complication from your surgery or another issue needing proper medical care. Always take your health seriously and listen to your body — no matter what.
How Can I Make Sex More Comfortable?
Painful sex after a hysterectomy isn’t something you just have to “deal with.” You deserve to have comfortable, satisfying sex as much as anyone else, and we’re here to help you do that. With a few tweaks and tips, your toes will curl again in no time.
One of the essential tools you can have in your post-hysterectomy toolbox is the right lubricant. A hysterectomy is usually done to manage a health issue, but that doesn’t mean there aren’t physical impacts on your body.
Most frequently, those impacts are related to the quick shift in your hormone balance post-surgically (especially if your ovaries were removed). For example, without as much estrogen in the body, the body may not respond to physical arousal by making its own lubrication.
Luckily, as frustrating as that lack of natural moistness can feel, commercially available lubricants can easily pick up the slack. Using lube, like a sex oil, supplements your body’s physical lubrication and decreases discomfort.
You don’t have to just use lube for “traditional intercourse” either — lube is excellent for all kinds of sexual activity, including self-love, manual stimulation (aka “fingering”), and anal play.
Just verify that your lube is compatible with how you plan to use it. Don’t use silicone-based lubes with silicone sex toys (it can speed up the degradation of the material), and avoid using latex condoms with oil-based lubes (as it can increase the risk of tearing).
Take It Slow
After you’ve had a hysterectomy, your body can also take longer to “warm up,” so to speak. While that may mean the number of quickies you have goes down, it’s a great excuse to really hone in on taking it slow and using foreplay to get you going before you get down.
Part of that process is talking to your partner about how you feel — physically and mentally. Don’t struggle in silence; include them in the process of finding new ways to turn you on.
Try an arousal oil to increase physical sensation, experiment with new positions and sexual activities, and have a steamy make-out session before taking your clothes off. You may be surprised by just how much of a turn-on it is to indeed be emotionally intimate with your partner — so many of us slack off in that department (especially when we’re in long-term relationships).
Check-In With Your Mental Health
Menopause can be tough, and you may find yourself having more of an emotional reaction to the process than you expected. Remember, there’s no right or wrong way to feel — just make sure to set aside time to check in with and honor your mental health. It’s about more than just having a healthy sex life; it’s about living your truth and being open and honest about your feelings.
For most people, sex is more than just a physical act — it’s an act of intimacy. If you’re not feeling good mentally, it can impact your ability to get your head in the game, get aroused, have an orgasm, etc. Taking care of your mental health can also help you have a more satisfying sex life, regardless of whether you’ve had a hysterectomy or not.
For some people, the painful intercourse and vaginal dryness they experience after having a hysterectomy require prescription intervention. Often, this comes in the form of hormone replacement therapy (HRT).
HRT is a way to supplement estrogen levels (occasionally along with other hormones, like progesterone) in the body, which can minimize side effects. HRT can be administered in various forms — creams, gels, vaginal suppositories, injections, skin patches, etc.
HRT isn’t for everyone, though. In some situations (like people with a significant history of breast cancer, blood clots, or at high risk for a stroke or heart attack), HRT may increase their risk of experiencing side effects. That is why HRT should only be prescribed after a visit to your doctor or gynecologist and be used under medical observation.
Your sexual health and wellness are important, no matter how old or at what stage in your life you find yourself. You don’t have to just put up with painful sex after a hysterectomy; you can take charge of your sex life and get it back on track.
Plenty of management and treatment options are available — some over-the-counter and some requiring a visit to your doctor — so don’t write a healthy sex life off just because you’ve had your uterus removed. You’re just as deserving of pleasure as everyone else, and we want to help you get it.
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