Does Sex Feel Different After a Hysterectomy?

A hysterectomy is unlikely to impair sexual function. And for many women, vaginal sensation and the ability to experience external orgasms through clitoral stimulation are not affected. 

Some women do, however, experience less intense vaginal orgasms or no orgasms at all after hysterectomy. This is because when the uterus is removed, the nerves that enable an orgasm (especially the nerves near the cervix) may get severed.

In some cases, if the ovaries are removed during the surgery, it can cause a decrease libido (desire for sex). This is because the ovaries produce estrogen and tiny amounts of testosterone, which are hormones that affect sex drive. 

Vaginal dryness may also be an issue if ovaries are removed, which can make the sex feel painful for some women. Using lubrication during sex can help resolve this problem. 

On the opposite end of the spectrum, some women have experienced better sex after hysterectomy. This is especially true for women who had sexual problems (pain during sex) before the surgery.

After a hysterectomy, it’s important for women to take their time before easing into their sex lives again. Talk to your doctors and partners about how you are feeling. If you are experiencing vaginal dryness, your doctor may recommend using vaginal estrogen creams, rings, tablets, or silicone-based lubricants to make the sex less painful.

Make sure to be honest in discussing with your partner what feels good and what doesn’t, and to experiment and figure out what feels comfortable for you. Couples may consider seeing a sex therapist or counselor to explore new options when restarting their sex life.

A hysterectomy is a surgical operation to remove the uterus. Not all hysterectomies are the same, however, and which type depends on the size and shape of the uterus, as well as the reason the surgery is being performed. 

• Vaginal hysterectomy: Uterus is removed through the vagina. 
• Abdominal hysterectomy: Uterus is removed through an incision over the abdomen.
• Laparoscopic hysterectomy: Uterus is removed via a small scope and with smaller incisions.

Following hysterectomy, a woman will no longer be able to get pregnant, and her periods will stop as well.

A hysterectomy may be performed in the following conditions:

• Cancer of the reproductive organs
• Uterine prolapse where the muscles and ligaments of the pelvis weaken causing the uterus to prolapse into the vagina
• Endometriosis where the endometrium (inner lining of the uterus) grows outside the uterus, affecting the ovaries, fallopian tubes, and other organs in the pelvis
• Fibroids which are benign tumors that form in the uterus
• Adenomyosis where the inner tissue lining of the uterus grows into the uterine wall
• Abnormal uterine bleeding which causes extremely heavy, painful, irregular periods that aren’t helped by medication and other less invasive procedures

Hysterectomy is recommended when other treatments are ineffective and if the condition can’t be managed conservatively or by other less invasive procedures.

During surgery

The surgery is usually performed under general anesthesia or spinal anesthesia (the lower half of the body is anesthetized). 

The uterus is detached from the upper portion of the vagina and fallopian tubes, ovaries, surrounding blood vessels, and connective tissues that support the uterus are removed. In some cases, the cervix may be removed as well. All the sutures (stitches) used are usually absorbable.

After surgery

Patients are usually discharged 24-48 hours after surgery and prescribed painkillers and antibiotics. 

You may experience bloody vaginal discharge for a few days to weeks after surgery and may need to wear sanitary pads. Complete recovery may take 6-8 weeks. The postoperative recovery period after vaginal hysterectomy is usually shorter and less painful compared to abdominal hysterectomy. 

Your doctor will also advise you to avoid lifting heavy objects or doing vigorous exercise for up to 6 weeks. Surgeons also recommend not to insert anything into the vagina for the first 6 weeks after surgery. Therefore, it is not recommended to have sex for the first 6-8 weeks after surgery.