Any concerns you might have regarding sexual relations following a hysterectomy should be discussed and doing so early in your recovery will create more openness and honesty between you and your partner. Waiting until just prior to the first sexual encounter may be a set-up for unmet expectations, disappointments, and intimacy problems down-the-road. Honesty is the best policy. You need to be upfront about your level of desire, what it takes to arouse you, and how you can best reach orgasm. Issues you encounter as you recover may include:

What if sexual intercourse is painful?

Pain during intercourse is most likely related to vaginal dryness. Lubrication may be affected either by the surgery or induced menopause. There may be decreased sensation in the vagina and clitoris, making arousal and orgasm more challenging.

Overcoming vaginal dryness will take a little planning. You can keep lubricants such as KY Jelly, Astroglide (both available in drugstore chains), or plain vegetable oil on hand for when you engage in sexual relations. Lubricating during sex will help eliminate painful intercourse. If you are dry through the day, Replens (available in drugstore chains) can be used on a more frequent basis. Talk to your doctor about hormone preparations such as Estring (vaginal estrogen ring; www.estring.com), Vagifem cream (www.vagifem10.com), or bio-identical hormones. If you have persistent pain, talk to your doctor. There may be solutions that increase your comfort during sexual relations.

What if I have difficulty getting aroused?

Unfortunately, as of yet, there are no sexual enhancement drugs on the market for females. Setting the mood can help with warm baths, massages, candles, and music. With your partner’s help, resume familiar foreplay and patterns. You might have to work up to intercourse. If it doesn’t happen initially, don’t give up.

Alternate arousal methods can be tried to enhance sensation in the vagina and clitoral area. Masturbation, oral stimulation, and use of a vibrator can be considered to increase arousal and intensity of orgasm.

I feel sad since my hysterectomy.

Loss of the reproductive organs can trigger a psychological reaction in some women. Sadness and sometimes depression can occur after hysterectomy. The uterus is a symbol of womanhood, productivity, and creation. If you find yourself unable to get past being sad or depressed, talk to your doctor. A short-term medication might help to get you back on track to feeling yourself.

Proper sexual positioning can be helpful in reducing pain during sexual intercourse.

Sexual Positioning following a Hysterectomy

A vaginal hysterectomy can result in altered sensation in the vagina. Scar tissue can cause discomfort. Proper sexual positioning can be helpful in reducing pain during sexual intercourse. The missionary position (man on top, woman on the bottom) can be painful as the penis is thrust toward the back of the vagina. It may be more comfortable to assume a face-to-face position. Your partner lies on his back with you sitting on top.

Hysterectomy can significantly improve your general health and well-being. You can return to sexual satisfaction and intimacy. Face the challenges your surgery presents to move on to a healthy and happy life.