Sexuality After Hysterectomy: What to Expect and How to Navigate Changes

Post-hysterectomy, it’s natural for concerns about sexuality to arise. Will pleasure feel different? Can intimacy be affected? This article demystifies sexuality after a hysterectomy, unpacking what changes may occur and ways to maintain or enhance your sex life. Read on to gain insights and reassurance for your post-surgical sexual health.

What to Expect from a Hysterectomy

When considering a hysterectomy, whether it’s a vaginal hysterectomy, abdominal hysterectomy, or a minimally invasive laparoscopic hysterectomy, it’s important to understand both the physical and emotional impacts it can have on your well-being and sexual function. While most women may experience improvements in sexual health, not all women will have the same outcomes.

Many women experience an improvement in their quality of life post-hysterectomy, thanks to the relief from symptoms like painful sex, heavy bleeding, and chronic pelvic pain. These positive effects can enhance sexual satisfaction and lead to greater enjoyment of sex.

However, it’s not uncommon for some women to experience challenges, including changes in hormone levels that might trigger menopause symptoms such as hot flashes and night sweats if the ovaries are removed. These changes can sometimes lead to a reduced sex drive (low libido), vaginal dryness, and discomfort during sexual activity if these are not treated with appropriate menopausal hormonal therapy (MHT).

Adjusting to your new body might require patience and open communication with your partner and medical team, that’s why this blog will touch on some of the key considerations and steps to help post hysterectomy patients feel confident and empowered after surgery.

Navigating Changes in Sexual Function Post-Hysterectomy

While the thought of sex after a hysterectomy may seem overwhelming, many women report improved or unchanged sexual function post-surgery. However, every woman’s journey is unique. Some may experience vaginal dryness, pelvic floor weakness, and changes in sexual sensation. These symptoms are managed with appropriate treatment.

Remember, your body goes through significant changes post-hysterectomy, and comprehending these transformations is a stepping stone towards a satisfying sex life after surgery.

Orgasm post-hysterectomy can, at times, be altered due to the absence of uterine contractions, potential nerve injury (rare), and changes to the blood supply even when the ovaries are preserved. However, the quality and intensity of orgasms should not be permanently prevented, and some women may actually experience an improved frequency of orgasms post-surgery.

The Timeline for Resuming Sex After a Hysterectomy

It’s natural to wonder when it’s safe to resume sexual activity after a hysterectomy. Dr Brooke O’Brien recommends waiting about  12 weeks after a hysterectomy before engaging in penetrative sexual activities such as intercourse. Other forms of intimacy may be enjoyable when you feel that you have healed, usually around 6 weeks. However, keep in mind that healing rates differ from person to person, so resumption of sexual activity should only occur when you feel fully prepared.

Sexual activity, including sexual intercourse, should only be considered when all surgery-related vaginal discharge has ceased and the wounds have sufficiently healed. When resuming sexual activity, ensure open communication with your partner and start gently, paying particular attention to any discomfort. 

After the recommended waiting period, if any discomfort or bleeding occurs during sexual activity, seeking medical advice is recommended. Remember, post-hysterectomy:

• The ability to have an orgasm should not be affected
• Sensation in the vagina should remain the same
• Hormonal changes due to ovary removal may affect sexual drive, which you should talk to your doctor about.

The Role of Pelvic Floor Muscles

Your pelvic floor muscles play a significant role in your sexual health post-hysterectomy. Properly performed Kegels can enhance pelvic floor strength after a hysterectomy, directly influencing your sexual experience. Moreover, pelvic floor exercises can reduce the risk or severity of incontinence, pain, and sexual side effects after a hysterectomy.

The Emsella chair uses HIFEM technology to stimulate pelvic floor muscles, effectively aiding muscle re-education and improving sexual function. Improvements in pelvic floor strength and sexual health symptoms can be observed quickly after the first Emsella session, with treatments typically spaced over three weeks.

Will I still experience sexual pleasure after surgery?

A hysterectomy might alter a woman’s sexual function, with some women encountering difficulties with orgasms or nerve damage (very rare), while others might note an improvement, particularly if painful intercourse previously hampered their sex lives. A hysterectomy can lead to vaginal dryness due to decreased blood flow and lubrication following ovary removal, which is treated with replacement estrogen. Some other tips for improving comfort and stimulation include:

• Experimenting with new sexual positions
• Using intimacy aids and devices to enhance stimulation
• Using a pH-balanced lubrication to increase comfort
• Communicating openly with your partner about any changes in bodily sensations and find ways to adapt and explore new experiences together.

Gradually easing back into sexual activities can be beneficial, with extended foreplay to build arousal and acknowledge that most changes in sexual function, like discomfort or arousal issues, are usually temporary and improve over time.

Communicating with Your Partner

Having open conversations with your sexual partner is essential for addressing needs, expectations, and sexual dysfunction following a hysterectomy. Communicating with your partner about changes in bodily sensations and what feels pleasurable can help readjust sexual expectations and experiences post-surgery, ultimately leading to a fulfilling sex life.

Engaging in discussions to determine comfortable sexual positions and communicate about any discomfort can lead to a more enjoyable sexual experience after surgery. Discussing emotional and physical feelings related to sexual activity can also provide opportunities for improving the sexual experience and tackling any issues that arise as a consequence of the hysterectomy.

Leveraging Nurture Gynaecology’s Expertise

Under the guidance of Dr. Brooke O’Brien, Nurture Gynaecology specialises in female health, providing services catering to sexual health concerns of women post-hysterectomy. Our clinic provides the Emsella treatment, a non-invasive approach that allows patients to comfortably address pelvic floor issues without taking time away from their daily activities.

The Nurture Gynaecology clinic is situated in a purpose-built facility in Brisbane’s North West, where we prioritise creating a supportive atmosphere with the privacy needed for discussing sexual health. We also offer telehealth consultations to ensure continuous support.

In conclusion, navigating changes in sexual health after a hysterectomy can be a complex, deeply personal journey. Understanding your body’s response, strengthening your pelvic floor muscles, and managing hormonal changes can greatly improve your sexual health post-surgery.

Remember, every woman’s experience is unique, and it’s important to communicate openly with your partner and seek professional help when needed. With the right support and guidance, you can regain and even enhance your sexual pleasure after a hysterectomy.