Does having a hysterectomy affect sex?

After a hysterectomy, a person should not put anything inside the vagina for around 6 weeks. After the body has healed, though, a hysterectomy usually does not affect sex.
For some, a hysterectomy may even improve sex, depending on the reasons for having one.
That said, some people do experience side effects after a hysterectomy. For example, if the surgery removes the ovaries too, changing hormone levels may affect sex drive. However, there are ways of managing these effects, if they occur.
The exact amount of time a person needs to avoid sex after a hysterectomy will vary depending on how long it takes for their body to heal. A doctor can tell when it is safe to resume sexual activity.
Keep reading to learn more about how a hysterectomy may affect sex.
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According to the American College of Obstetricians and Gynecologists (ACOG), people should refrain from putting anything in the vagina for about 6 weeks after a hysterectomy. This includes a penis, fingers, sex toys, and tampons.
American College of Obstetricians and Gynecologists (ACOG)
However, it is important to note that this timeline is based on average healing times. Some may heal more quickly or slowly than others.
Doctors recommend that people refrain from sexual activity after a hysterectomy until all surgery-related vaginal discharge has stopped and wounds have healed. They can tell someone when it is safe for them to resume sex based on their individual situation.
a hysterectomy
vaginal discharge
Some types of sex, such as oral sex or clitoral stimulation, do not involve inserting anything into the vagina. There are no official guidelines on when a person can resume these activities, or when it is safe for them to have an orgasm after a hysterectomy.
It may be worth asking a doctor how long a person should avoid orgasms, if at all.
How do hysterectomies change sex?
Although a hysterectomy changes a person’s fertility, it usually does not affect the ability to enjoy sex. In many cases, people can resume a healthy, fulfilling sex life after healing.
fertility
In fact, a 2020 cohort study found that sexual function scores increased in participants at 3 and 12 months after a hysterectomy.
2020 cohort study
Some of the effects a hysterectomy may have on sex include:
Less pain or discomfort: A hysterectomy may relieve a variety of symptoms that made sex uncomfortable before surgery, such as pain or heavy bleeding. Relief from these symptoms may make sex after a hysterectomy more enjoyable than before surgery.
heavy bleeding
Same sensation: Hysterectomies remove the uterus and cervix, but the vagina and clitoris stay intact. As a result, sex should still feel the same as before the surgery.
cervix
Slightly shorter vagina: The vagina may be slightly shorter after a hysterectomy than before, but this can vary depending on the type of procedure.
slightly shorter
As long as a person has had sufficient time to heal, bleeding or pain should not occur. If bleeding or pain does occur during sex, talk with a doctor.
Do hysterectomies affect libido?
After a hysterectomy, it is typical to experience some pain for a few days. A person may also experience constipation, and there may be vaginal bleeding or discharge for several weeks after surgery. This may mean a person temporarily has less interest in sex.
a few days
constipation
For many, their sex drive may return to typical levels after healing. But for others, the surgery itself may change how they feel about sex. This could be due to:
sex drive
A hysterectomy can have a significant emotional impact. It may affect how a person feels about their body or identity. The surgery may also influence future plans to have a family, or may have occurred due to a serious illness. Any of these factors could affect a person’s interest in sex.
A small 2023 study interviewed 18 women who underwent a hysterectomy below the age of 39. Some reported feeling less feminine after their surgery. However, others felt more feminine because they were less worried about symptoms such as bleeding, resulting in a sense of freedom.
small 2023 study
There is no right or wrong way to feel about having a hysterectomy. It is important for people to be compassionate towards themselves. If they feel distress about the surgery or how it has affected their mental health, it may be beneficial to speak with a therapist.
Hysterectomies only remove the uterus and cervix, but sometimes, surgeons may also remove the ovaries. When this happens, it induces menopause, leading to a reduction in estrogen. This may affect a person’s sex drive, too.
estrogen
Sex and surgical menopause
People who undergo hysterectomies with bilateral oophorectomy, or the removal of both ovaries, enter “surgical menopause”. This is because the ovaries produce much of the estrogen in the body, as well as other female reproductive hormones. Without them, the hormones decline.
oophorectomy
This does not result in sexual symptoms for everyone, but it can. People may experience:
thinner vaginal tissues
vaginal dryness
vaginal dryness
lower libido
Other potential symptoms include:
hot flushes
night sweats
shifts in mood
These changes may reduce desire or make some sexual activities uncomfortable. However, there are treatments that can help, such as:
over-the-counter lubricants
vaginal moisturizers
hormone replacement therapy
Learn more about surgical menopause and what to expect.
surgical menopause and what to expect
Other complications of a hysterectomy
Hysterectomies are one of the safest surgical procedures, but all surgeries have some risks. Some other potential complications of hysterectomies that may affect sex include:
one of the safest
Pelvic floor dysfunction is when a the muscles holding organs inside the pelvis do not relax and contract as they should, which can affect sexual function, as well as urination and bowel movements.
Pelvic floor dysfunction
The potential link between hysterectomies and pelvic floor dysfunction is controversial. A 2022 study found that several types of hysterectomy improve pelvic floor function overall 6 months after the surgery.
2022 study
However, other researchers believe there is a relationship. In a 2021 study, the researchers suggest that the link may be due to nerve damage that occurs during the operation.
2021 study
Currently, there is no conclusive proof that hysterectomies directly cause pelvic floor dysfunction. More research is necessary to understand if hysterectomies can have this effect, and if so, how high or low the risk may be.
Doing pelvic floor exercises, such as Kegels, may strengthen the pelvic floor muscles after surgery.
pelvic floor exercises
Some people report a reduction in sensation inside their vagina during sex after a hysterectomy. This does not necessarily affect orgasms, though, as it should not affect the clitoris.
Still, changes in sensation inside the vagina may affect what sex positions or techniques feel good.
Some people experience pain during sex after a hysterectomy. This may get better with time, but for others, it can be persistent.
pain during sex
Some research points to shortening of the vagina as a potential cause. This may happen more often in some types of hysterectomy than in others.
Some research
However, scientists are still learning about what might cause pain after hysterectomies.
Tips for sex after a hysterectomy
Some may feel a little apprehensive about having sex after a hysterectomy. There are several things a person can do to make it easier, including:
Not rushing things: Having sex too soon after surgery may be painful or cause an infection. A person should follow the doctor’s recommendations about when it is safe to have sex, remembering that 6 weeks is only a guide. Some people may not be ready at that point in their recovery.
6 weeks
Talking with their partner: It is important to talk with any sexual partners about how they feel after a hysterectomy, especially if something is painful or uncomfortable.
Using lubrication: Using lubrication may make sex easier and more enjoyable. Lubrication may be especially helpful for people who are in surgical menopause.
Trying different positions: Certain positions may be more comfortable than others, especially for people who are experiencing vaginal dryness. In these cases, they can experiment with different positions to find something that feels better.
Summary
A person’s sex life can be just as good, or possibly better, after having a hysterectomy. It may reduce symptoms that previously interfered with sex, such as pain or bleeding.
However, everyone heals differently and at a different pace. People will need to avoid inserting anything into the vagina for some time after a hysterectomy. There can also be emotional or hormonal changes that affect sex, depending on the situation.
People who experience persistent sexual problems after a hysterectomy, such as pain or a reduced sex drive, should talk with their doctor for advice. There may be treatments that can help.