It takes time to get back to normal after an operation, but having a hysterectomy can have a strong emotional impact too, which can affect how you feel about sex.
If you experience problems with sex after your operation, don't suffer in silence. There is help available – you can talk to your GP, a counsellor or an organisation such as the Hysterectomy Association.
How long should you wait before having sex after a hysterectomy?
You will be advised not to have sex for around four to six weeks after having a hysterectomy. This should allow time for scars to heal and any vaginal discharge or bleeding to stop.
If you don't feel ready for sex after six weeks, don't worry – different women feel ready at different times.
There are many different types of hysterectomy, which will affect how it is performed and what is removed.
A total hysterectomy is the removal of the uterus (womb) and cervix. If the cervix remains intact, this is a subtotal hysterectomy. Sometimes the ovaries or fallopian tubes are removed as well.
Which organs are removed will depend on your own personal circumstances and the reasons you're having a hysterectomy.
Bleeding after sex after a hysterectomy
Any woman who notices bleeding after sex should see a doctor to find out why it is happening. This includes women who have had a hysterectomy. Your doctor may be able to offer treatment, and can check that everything is healing well.
Feeling sexually attractive
Having the uterus removed can cause women to worry about feeling less womanly, or losing their sexual attractiveness. Many women also talk about feelings of loss or sadness after a hysterectomy. However, these feelings should pass.
You may find it helps to focus on your recovery – eating healthily, getting some exercise (your doctor will tell you how much activity you should aim for) and talking to your partner or friends about how you're feeling.
If you're finding it hard to cope with these emotions, talk to your GP or consultant. You may be able to have counselling to help you work through your feelings. Find a counsellor near you.
It can also help to read about how other women have coped with similar experiences. You can read about women's experiences of hysterectomy at healthtalk.org.
Sex and menopause
If you have your ovaries removed as well as your uterus, this will trigger the menopause whatever your age. The change in hormone levels that occur during the menopause can affect your sex life. Read more about sex after menopause and how to deal with any problems.
Some women have less interest in sex after having a hysterectomy. If this happens to you, your interest in sex may return as your recovery progresses.
If you and your partner feel it's a problem, talk about it together so that it doesn't become an unspoken issue between you. You can also talk to your GP or find a counsellor who can offer help with sexual problems.
Our talking about sex page has tips from a psychosexual therapist, which you might find useful.
Lack of sex drive can be made worse by depression, menopausal symptoms, relationship problems and stress. These problems are often temporary, but if symptoms of the menopause or depression persist, see a doctor. Treating menopausal symptoms may boost your sex drive indirectly by improving your general wellbeing and energy levels.
Read more about keeping the lust alive.
Vaginal dryness, sensation and orgasm
Having a hysterectomy doesn't mean you can't have an orgasm. You still have your clitoris and labia, which are highly sensitive.
It's not known what role the cervix plays in orgasm. Some experts have argued that removing the cervix can have an adverse effect, but others have found that it doesn't.
A review of the evidence comparing subtotal with total hysterectomy in premenopausal women found both types offered similar results for sexual function.
In a study comparing different surgical methods of hysterectomy, a number of women noticed reduced sexual sensation. This included reduced feeling when their partner penetrated their vagina, a dry vagina and less intense orgasms. If, before hysterectomy, you had noticeable uterine contractions during orgasm you may find you don't experience these anymore.
If your hysterectomy has made your vagina feel drier than it used to be, try using a sexual lubricant. You can buy these over the counter at a pharmacy.
Your surgeon will have advised you to do pelvic floor exercises to help your recovery. These exercises can also tone up the muscles of your vagina and help improve sexual sensation. Read more about pelvic floor exercises.
Other women in the study mentioned above said their hysterectomy had removed their pre-surgery symptoms (such as pain), and they had a greater sense of wellbeing and happiness.
The Royal College of Obstetricians and Gynaecologists has leaflets about recovering after hysterectomy:
Recovering well after abdominal hysterectomy
Recovering well after vaginal hysterectomy
Recovering well after a laparoscopic hysterectomy