Enjoying Sex after a Hysterectomy

Enjoying Sex after a Hysterectomy

People have a hysterectomy for many reasons, including:

Many worry that having a hysterectomy will bring their sex life to an end but this generally isn’t the case. Often sexual pleasure and wellbeing improves as symptoms such as pain and vaginal bleeding are reduced or even disappear.

However, some can experience new sexual health problems as a result of surgery, many of which can be overcome by seeking appropriate medical advice and therapy or even self help.

How soon can I have sex after a hysterectomy?

This depends on the type of hysterectomy you have had. Many gynaecologists recommend 4-6 weeks, but generally 6 weeks if you have had your cervix removed as it needs time to heal. However this advice can vary between gynaecological departments and following the type of hystrectomy you had.

Some gynaecologists are advising patients not to have sex for 12 weeks following laparoscopic hysterectomies & radical laparoscopic hysterectomies as they had reports of vaginal cuff dehiscence which refers to separation of the vaginal incision. The vaginal incison is the point at which the uterus is removed and is typically sutured closed after removal of the uterus so it is essential that this wound is completely healed. Therefore it is important to follow the advice from your healthcare professional.

If you have had an abdominal hysterectomy, you will have an abdominal scar which may feel uncomfortable while it heals, so you may wish to have sex on top to avoid any abdominal pressure being put upon the wound or you may want to wait until the wound is completely healed.

This advice relates to coital sex, but non-coital sex such as masturbation, oral sex and using a sex toy on your clitoris should be fine. If you are still bleeding, then it is advisable to abstain until the bleeding has stopped. If you use a sex toy, always ensure that it is clean before and after use to prevent infection.

You can speed up your recovery by taking regular exercise and eating healthily too.

Will it impact upon my sexuality?

A hysterectomy is the removal of the uterus, sometimes the ovaries, fallopian tubes or cervix too, depending on the type of surgery you are having. Having your uterus removed can make some people feel less sexually attractive. Many report feeling a sense of loss or sadness at the removal of their sexual organs even if the operation resolves gynaecological problems, such as bleeding and pain. This is because it means the end of their chances of having children, even if their family is complete.

However, for many the freedom from painful debilitating symptoms can allow them to lead a normal life again.

Undergoing an abdominal hysterectomy, whereby the hysterectomy is removed through the abdomen, will leave a scar, which may affect the way you feel about your body. However, this scar is often small in size and sits below the panty line.

Having a hysterectomy can shorten the vagina, making it feel uncomfortable during sexual intercourse. Using medical or silicone dilators or a slim vibrator can help stretch the tissues of the vagina, making sex feel more pleasureable.

Many people worry uneccessarily that their partner won’t find them attractive but often having a hysterectomy can boost sexual pleasure as it resolves gynaecological problems such as painful periods, hormonal health issues, bleeding and abdominal discomfort, all of which can impact negatively upon sexual function and intimacy. Having a supportive partner can speed up your recovery, helping you to return back to normal.

Discussing how you feel about having a hysterectomy with your partner, GP, consultant gynaecologist, nurse or the charity Hysterectomy Support can help allay any fears and provide answers to questions you may have before you undergo surgery and post operatively.

Will it send me into the Menopause?

If your ovaries are removed, all HRT options should be discussed with you pre or post op as this will send you into a surgical menopause. For clinical evidenced based information take a look at the NICE Menopause guidelines and the excellent menopause medical and healthcare professionals and resources listed below.

Local oestrogen can transform your sex life

If your ovaries are removed the lack of oestrogen can make the vaginal tissue to shrink, feel less well lubricated and even thin which can lead to painful sex and vulva and vagina health issues. It can also cause recurrent urinary tract infections and cystitis. However, using local oestrogen can be a game changer when it comes to enjoying pleasurable sex and preventing genitourinary issues. Many people only start using local oestrogen when they have issues yet it can prevent many issues from happening. Local oestrogen which comes in pessaries, cream and ring pessaries is absorbed in the vagina, vulva and bladder replacing the depleting oestrogen to keep the tissues flexible, promote lubrication and prevent infections and irritation. The vast majority of people with a vulva and vagina can use local oestrogen so speak to your GP or a menopause expert. Some people choose not to use it, others don’t know what it is and some people may not be able to use it.

Going through the menopause doesn’t mean that you will experience the same symptoms that other women do as everyone is different. Some women experience hot flushes and night sweats, others have vaginal dryness and lower libido. For younger women the impact of an early menopause and not able to have children can be life changing. Discussing this with your consultant is important and they will refer you for counselling which may help.

Your sex life doesn’t have to stop or feel less pleasurable when you go through menopause, there are so many ways in which to enjoy a great sex life.

Vaginal Dryness

Vaginal dryness is easily overcome by using sexual lubricants and hormonal creams and pessaries.

Using a good lubricant such as YES organic lubricant is excellent for nourishing the delicate skin of the vagina and improving the elasticity of the walls of the vagina which can be affected by a decrease in oestrogen if the ovaries are removed. It also makes sexual intercourse feel great.

Skin safe, odourless and tasteless, YES organic lubricants are similar to your body’s natural lubricant and do not contain chemicals which may cause allergic reactions and genital irritation.

Avoid using products that are not designed for the vagina. Just because a food stuff can be eaten does not mean it is good for your vagina health and avoid using products in your bathroom cabinet, such as vaseline too.

Some products designed as vaginal lubricants, even those available on prescription from your GP may cause vaginal irritation or infection as many contain glycerin which can cause thrush and alter the pH of the vagina.

Often recommended and prescribed by GPs and HCPs, many waterbased lubricants contains glycerin, glycols and parabens which can irritation. Many water based lubricants have a higher osmolality than the cells in the body, drawing moisture out of the walls of the vagina rather than hydrating them, exacerbating vaginal dryness, not helping it. This can leave the body vulnerable to infection, such as thrush which is often more prevelant after cancer treatment.

YES VM is ideal for restoring moisture and the pH balance of your vagina. Coming in handy 5ml dose applicators it lasts up to 3 days per application and being bio-adhesive means it releases moisture where needed. Being hormone free it is great for those unable to use local oestrogen.

SUTIL LUXE is a silky smooth water-based lubricant that moisturises, nourishes and soothes our most intimate areas, as well as lubricating for sexual pleasure. Feeling like a silicone lubricant without the silicone, this fabulous water based lubricant gently cushions and glides, blending seamlessly with your own natural lubrication during sex. Being water based it is easy to wash off too.

Free from irritating ingredients and hormone free it is perfect for anyone, including those not able to have hormone replacement therapy and post cancer treatment, not only as a sexual lubricant but also as a vaginal moisturiser and can be used with any sex toy or dilator.

Made with eco certified ingredients SUTIL is committed to creating natural and organic cosmetics that are not only great for your skin, but also derived from renewable resources and manufactured using environmentally friendly processes. Even the sleek tube is biodegradable.

However, if you experience pain or discomfort when having penetrative sex, you can still enjoy non-coital sex with your partner through mutual masturbation, oral sex and sex play with a clitoral vibrator to experience orgasms.

It is really important to look after your intimate health yet frustratingly our vaginas are being bombarded with feminine hygiene products , the vast majority of which we do not need and are detrimental to our vagina health, friendly vagina bacteria, sexual pleasure and wille xacerbate vaginal dryness and atrophy. So avoid using intimate washes, douches, sprays, scented menstrual products, bath bombs and perfumed condomsto enjoy better sex.

Will my libido decrease?

Some people may find that they don’t want to have sex after having a hysterectomy but this is often temporary. The general advice is to abstain from having sex for 6 weeks post operatively but some women may take longer to resume normal sexual activity. This also depends on how good their sex life was before having surgery.

Talking to your partner can help because they may be feeling just as anxious as you about resuming sexual intercourse and worry about hurting you, or may feel rejected by your behaviour and are unable to understand why you are feeling like this.

If you continue to feel anxious or just not interested in sex after a few months, seek medical advice. Low libido is often caused by the menopause, depression, sexual side effect to some medication, stress, body image or relationship issues. Treating changes in hormone levels or symptoms of depression with medication can indirectly boost your sex drive, improving your general well being and sexual health too.

If you find that your libido is still low and you have no interest in sex after hormone treatment, speak to your GP or consultant. They can refer you for relationship counselling with a psychosexual therapist who will be able to offer advice to both you and your partner.

Will I still be able to have an orgasm?

Having a hysterectomy has no impact upon your ability to orgasm as your clitoris still remains intact. 70% of people with a clitoris and vagina orgasm clitorally, and regular masturbation or using a sex toy is highly recommended!

Some people find they experience less intense orgasms or decreased sensitivity as a result of scar tissue or nerve involvement. If you experience decreased sensation, using a powerful vibrator, such as a Doxy can improve your sexual pleasure in addition to soothing your aches and pains, the Satisfyer Pro 2, a unique clitoral stimulator which use pulsation waves to gently suck your clitoris or the gorgeous LELO SONA 2 which gently teases your clitoris using sonic wave technology.

If sex feels painful, always stop. Painful sex is not pelasurbale sex and it indicates something is not right. It may be as a result of scar tissue causing vaginal tightness, reduced vaginal secretions, shortening of the vagina, a common issue post hysterectomy or anxiety that it will feel painful or different. Take your time and go at your own pace, there is no rush.

Many gynaecologists recommend using a small vibrator and plenty of lubrication to help stretch any scar tissue and increase the healing process by improving the blood supply to the surrounding area. Massaging lubricant into the scar tissue can help it become more elastic and promote healing.

The Picobong Zizo, OhMiBod Cuddle and Je Joue Uma are excellent vibrators as they are slim in size and made from skin safe silicone which feels very gentle against the delicate tissues of the vulva and vagina.

Even when coital sex is not possible, you can still enjoy sexual pleasure through masturbation, oral sex or incorporating sex toys into your sex play whatever their gender.

I can’t orgasm during sex anymore

Removal of both the uterus and cervix can affect the intensity and quality of orgasms as both the uterus and vagina muscles contract during orgasm. Also, if the nerve pathways involved in sexual response and vaginal orgasms are damaged or cut, this can affect the ability to orgasm.

Removing the cervix may affect orgasms as it plays a major role in orgasm by dilating to improve chances of conceiving and it is incredibly sensitive to touch. The pressure from the penis can trigger an orgasm by stimulating the nerve endings on the outside the cervix.

If there is no need to remove your cervix, ask that it is left intact as many women enjoy cervical orgasms during sexplay.

Many people who say this pressure is a trigger for their orgasm find they’re unable to orgasm during penetrative sex after hysterectomy if their cervix is removed.

You can overcome this problem by experiencing clitoral or G-spot orgasms. Stimulating your clitoris through masturbation or using a vibrator can produce intense orgasms which can be just as pleasurable as vaginal orgasms. Using a small bullet or clitoral vibrator during sexual intercourse can help you achieve an orgasm. Having a clitoral orgasm during foreplay allows you to concentrate on all the pleasurable, sexual sensations happening to your body during sex, rather than fixating on whether or not you will orgasm.

Stimulating your G-spot through manual stimulation or by using a G-spot vibrator or dildo, specifically shaped to pleasure this extremely sensitive area for intense orgasms. By changing the way in which you orgasm, you can still enjoy intense, pleasurable orgasms.

I pee when I cough now

You may find you pee a little when you cough, especially after having children or gynaecological surgery as the Pubococcygeus muscles (PC muscles), or pelvic floor muscles become stretched and lose their tone. Therefore, exercising your PC muscles on a daily basis can help them become more toned and stronger, which in turn, can help you to have more intense orgasms and stop you from peeing when you cough or sneeze.

Pelvic floor exercises (PFE) are so important and ideally should be done daily to reap the benefits. If you haven’t been shown how to do PFEs or are not sure you are doing them correctly, seek advice from a pelvic health physiotherapy who will be able to teach you how to do them.

Pelvic Floor Exercisers

Lelo Luna Balls help you perform pelvic floor exercises correctly so that you can effectively target the intended muscle. The exercises for women follow a sequence of squeezing, holding, and releasing of the PC muscles. At first you may find it difficult holding the PC muscles contracted but regular practice will help you to improve.

OhMidBod LoveLife Flex set of Kegel exercise weights are a great way to take control of your pelvic floor health and strength.The Flex weights are suitable for beginners due to their unintimidating size, and they are made from skin safe silicone, making them easy to insert and to clean too.

The set includes 3 weights for graduated training purposes, ranging from 35g to 85g, which aim to help you contract your PC muscles, toning your pelvic floor over time for improved vaginal health as well as stronger orgasms!

The Lelo Luna Smart Bead is a vibrating pelvic floor exerciser which offers a daily 5 minute exercise programme to follow and allows you to track your progress by increasing the strength of vibrations, the stronger your PC muscles become. Really easy to use, you can slip it in for just 5 minutes and then pop it out when the exercise programme has ended.

The MyStim range of vibrators are ideal if you want both a vibrator and a pelvic floor exerciser as they combine vibratory and electrical stimulation and have a pelvic floor exercise programme to follow.

The Squeezy App, created by a pelvic health phsyiotherapist can be downloaded to your phone to help you exercise wherever and whenever you want to.

Don’t give up on your sex life after having a hysterectomy, there are many ways in which you can still enjoy sexual intimacy and pleasure. Seek medical advice if you find that you are unable to have sex or it feels uncomfortable and consider some of the ideas mentioned above to help you and your partner continue to enjoy pleasurable sex.

At Jo Divine we believe that sexual health and sexual pleasure go hand in hand and have created a health brochure with suitable products to help people with sexual issues. Working with medical professionals, we hope to encourage patients and HCPs alike in talking more freely about sexual problems. A health issue doesn’t mean your sex life will have to stop!

If you would like more advice please give us a call.

Useful Websites

We work with many of these amazing people, charities and support groups.

Dr Louise Newson
Newson Health
The Menopause Charity
Dr Hannah Short
The Daisy Network – charity for premature ovarian insufficiency
British Menopause Society
Royal College of Obstetrics and Gynaecology
Menopause Support
Menopause Support for LGBTQIA
Trekstock
IAPMD
Mpowered Women
“Latte Lounge”:
“College of Sex and Relationship Therapists”: :https://www.cosrt.org.uk/
Womb Cancer Support: www.wombcancersupportuk.weebly.com
Eve Appeal: www.eveappeal.org.uk
Shine Cancer: www.shinecancersupport.org
Clic Sargeant: www.clicsargent.org.uk
Macmillan: www.macmillan.org.uk
GRACE (Gynae-Oncology Clinical Research and Excellence): www.grace-charity.org.uk
Pelvic Roar
Pelvic, Obstetric and Gynaecology Physiotherapy