A hysterectomy is a surgical procedure during which a woman’s uterus is removed.
The uterus, also known as the womb, is where a baby grows during pregnancy.
Hysterectomies are some of the most common surgeries done in women.
Some studies show that up to 33% of women in the US have a hysterectomy before they hit 60 years of age.
The procedure is done to treat many health conditions, including uterine fibroids that cause severe pain or bleeding, endometrial cancer, cervical cancer, adenomyosis, and endometriosis.
For women undergoing a hysterectomy, concerns about post-operative changes in their sex lives may arise.
In this article, we tell you everything you need to know about sex after a hysterectomy, including what to expect, how soon you can get back to being intimate, where sperm goes after a hysterectomy, and some tips for better sex.
How does sex change after a hysterectomy?
A hysterectomy usually does not affect your ability to have and enjoy sex. Most women go back to having healthy and fulfilling sex lives after they have healed from the operation.
In one review of studies, the majority of women reported that their sex lives remained the same or even improved after a hysterectomy.
If you had a condition that caused you a lot of pain and heavy bleeding, which made sex uncomfortable, you are likely to enjoy sex more after the procedure relieves you of these symptoms.
What to expect during sex after a hysterectomy
While some women do not experience any changes in their sexual function or sensations after a hysterectomy, others do.
We discuss some of these possible changes below:
1) Change in orgasms
One common question people ask is, “Can you have an orgasm after a hysterectomy?” The short answer is, of course!
Women can continue to have orgasms after the procedure. However, the nature of these orgasms may change.
A woman can have various types of orgasms. These include uterine, vaginal, and clitoral orgasms.
You’ll not be able to experience uterine orgasms after the procedure. If that used to be your usual type, you can work on relearning and experiencing other ways to reach an orgasm.
Depending on the type of hysterectomy, vaginal orgasms may or may not be affected. A radical hysterectomy involves removal of the top part of the vagina. This may result in reduced sensation, which may affect your ability to achieve a vaginal orgasm.
Fortunately, most women experience more clitoral orgasms, and these are in no way affected by the surgery.
2) Vaginal dryness
During some types of hysterectomies, your ovaries and fallopian tubes may be removed along with your uterus. In this case, one of the issues you may experience is vaginal dryness.
Your ovaries normally release hormones that are important for various functions.
One of these hormones is estrogen. It is important for keeping your vaginal area moist and supple.
A drop in estrogen levels can lead to thinning of the vaginal wall and decreased lubrication.
Fortunately, there are various treatment options available. These include vaginal moisturizers, lubricants, and hormonal therapy.
3) Low libido
Libido is a complex thing and is different for everybody. A low sex drive post-hysterectomy can be the result of a wide variety of causes.
If your ovaries were removed during the procedure, the drop in hormonal levels may lead to decreased sex drive.
This does not mark the end of your sex life, however. Hormone replacement therapy is an option.
For some women, the impact of losing a part of themselves can take a toll on their mental health and sex drives. In this case, counseling and therapy are options that can help.
4) Physical changes
While it is rare, a hysterectomy can lead to scarring and a change in the position of the pelvic organs.
This may cause pain and discomfort during sex, leading to anxiety, frustration, or complete avoidance of sex.
Communicating with your partner, experimenting with new sex positions, and maximizing foreplay may help improve this problem.
Speak with your doctor if you have persistent sexual dysfunction after your uterus removal surgery.
Tips for better sex after hysterectomy
Getting back to being intimate after a hysterectomy can be a process full of nerves and uncertainty for you and your partner. Here are a few tips to help you smoothly get back on track:
1) Don’t rush things
Follow your doctor’s recommendations about when it is safe to start having sex again. Sex too soon after the hysterectomy can cause pain and increase your risk of an infection.
When you do start having sex, take things slow. Vigorous penetrative sex may feel uncomfortable at first.
You may need to explore non-penetrative options for a while and have gentler sex.
2) Try new positions
It may take some trial and error to find new ways to experience sexual pleasure. Some sexual positions that were fine before may feel uncomfortable after the hysterectomy.
Explore new positions and activities to find things that are pleasurable and comfortable for you and your partner.
3) Communicate
You need to be open with your partner about how you are feeling. Tell them if something makes you feel good and when something hurts.
4) Use lots of lube
If you’re struggling with vaginal dryness after a hysterectomy, using lube generously may make sex easier and more pleasurable. Vaginal moisturizers are another longer-lasting option.
Best sex positions after hysterectomy
Everyone is different and will respond to a hysterectomy differently. Some women may be able to go back to enjoying sex in the same positions that they always have. Others may need to find new ways to enjoy intimacy.
Some positions may put a lot of pressure on the pelvic area and can cause pain or discomfort, e.g., the traditional missionary position in which your partner may put their weight on your abdomen.
The best sex positions that may reduce pelvic pressure and improve sex after a hysterectomy include:
Being on top
After their surgery, some women may experience pain deep in their vaginas during penetration.
Being on top allows you to control the rate and depth of penetration. That way, you can keep penetration at a level that you’re comfortable with.
From cowgirl and reverse cowgirl to the lotus position, you can explore a wide variety of on-top positions.
Lying on your side
Just like being on top, side-by-side positions allow you to control the pace and depth of penetration. You can try both face-to-face and back-to-front positions.
Doggy style
It is important to make the most out of clitoral stimulation after a hysterectomy, and the doggy position is one in which you can.
Either you or your partner can reach for your clitoris while having sex in this position.
There are lots of variations you can try out. Lying flat on your stomach instead of being on your knees is great because it automatically reduces the depth of penetration.
Another option is standing with your hands against a wall or leaning over a piece of furniture. This gives you more control over the depth of penetration.
Plus, it’s a great way to change the “sex in bed” routine and spice things up.
It’s important to remember that what works for one woman may not work for another. The above positions may not work for everyone.
The keys to finding positions that work for you after your hysterectomy are communication and experimentation.
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How soon after a hysterectomy can you have sex?
The American College of Obstetricians and Gynecologists (ACOG) recommends that women who’ve had a hysterectomy should not insert anything in their vaginas for six to eight weeks.
This includes penises, sex toys, fingers, douches and tampons.
There are currently no official guidelines on when it is safe to have non-penetrative sex or practice self-stimulation after a hysterectomy. Just remember that you need to give your body time to heal.
Non-penetrative sex and self-stimulation may lead to orgasms. Orgasms tense your pelvic muscles and may put a strain on healing wounds.
Listen to your body
It is important to note that the general guidelines are based on the average time it takes for women to heal.
You may need more time than what is recommended. Also, your doctor may recommend a timeframe different from the general guideline based on the type of surgery you had. Follow their advice.
It is normal to experience mild pain and vaginal bleeding for a few weeks after the surgery.
But, if you give yourself sufficient time to heal, you should not experience bleeding and pain during or after sex. Seek medical attention promptly if you do.
Where does sperm go after hysterectomy?
Since a hysterectomy involves the removal of the womb, sperm can no longer travel upward and into the uterine cavity. They simply stay in the vagina and eventually flow out with normal vaginal secretions.
FAQs
Yes, if the fallopian tubes and ovaries are left in place, it is possible for a woman to get pregnant after a hysterectomy. However, this is very rare.
If your ovaries are intact after a hysterectomy, you can still ovulate. The eggs released normally get degraded.
But, if they manage to get fertilized, the embryo may grow and attach to the fallopian tubes or some other abnormal spot in the abdomen because there is no womb to carry the pregnancy.
This is called an ectopic pregnancy. It is a potentially fatal condition that can lead to serious internal bleeding and death.
You cannot carry a pregnancy by yourself after a hysterectomy, but you still have options if you want to start or grow your family after the procedure. These include adoption and surrogacy.
The majority of men don’t report feeling any difference in sensation or having decreased sexual satisfaction after their partner has undergone a hysterectomy.
Conclusion
A hysterectomy is a surgical procedure that involves the removal of the uterus. It may also involve removal of the fallopian tubes and ovaries.
Communication and experimentation are the keys to maintaining and improving your sex life after a hysterectomy.
Most women don’t experience any changes and resume their normal sexual activities after recovering from the surgery. Others even report having improved sexual experiences.
However, some women experience decreased libido, vaginal dryness, physical changes, and a change in the nature of their orgasms.
Fortunately, there are lots of solutions to these possible changes after a hysterectomy.
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