What does a woman's life look like after hysterectomy? If you are going to have such an operation, or if you have already had it, then what will your life look like from now on? Read the article and we will try to help you find out.

Did you know that in certain situations, your sex life can actually improve after a hysterectomy? But indeed, there are also cases when side effects occur. Of course, all this depends mainly on the reason for which the procedure was performed. So in this article we tell you all about the recovery process and life after hysterectomy.

What is hysterectomy

A hysterectomy is the surgical procedure to remove the uterus (you'll see the term extirpation often used). After caesarean section, this is the second most common surgery for women. In the US, approximately 300,000 hysterectomies are performed annually.

Hysterectomy treats serious medical conditions, so your doctor may recommend this operation as a last resort to relieve certain symptoms, or even to save your life when:

• You have abnormal or heavy vaginal bleeding and no other treatment is working

• You suffer from endometriosis, adenomyosis, or have very strong menstrual pain during menstruation, and it does not improve with any other treatment

• You suffer from endometrial hyperplasia

• You have severe pelvic pain associated with the uterus, which cannot be reduced with other treatments

• You have uterine fibroids or recurrent uterine polyps

• You suffer from uterine prolapse (when the ligaments and muscle fibers weaken so much that the uterus descends towards or into the vagina)

• You suffer from or are at high risk of uterine or cervical cancer.

Depending on the reason why it is needed, several types of hysterectomy can be performed: sometimes only the upper part of the uterus is removed, and sometimes the fallopian tubes, cervix and ovaries are also removed.

Since the uterus is where the baby develops, two immediate consequences will be the disappearance of menstruation and the impossibility of a future pregnancy.

Types of hysterectomy

There are several types of hysterectomy, depending on the severity of the condition. The doctor will first make sure that he only recommends this procedure to you when it is 100% necessary for your life and reproductive needs.

Once this is established, we will discuss the type of hysterectomy recommended for you, i.e. whether or not the fallopian tubes and ovaries need to be removed:

• Partial hysterectomy
• Total hysterectomy
• Radical hysterectomy

Partial hysterectomy (supracervical)

Through a partial or subtotal hysterectomy, the doctor removes only the upper part of the uterus (hence the name supracervical). The cervix remains intact.

Partial hysterectomy can be performed vaginally, abdominally, or laparoscopically, and may be recommended to treat abnormal bleeding, pelvic pain, endometriosis, uterine fibroids, uterine prolapse, or certain types of cancer (ovarian, cervical, or uterine).

Total hysterectomy

Surgery to remove the entire uterus, including the lower part along with the cervix, is called a total hysterectomy. In this case, the ovaries are not removed.

Usually, total removal is recommended if there is a high risk of cancer or other gynecological conditions, in which case total hysterectomy is performed as a preventative measure.

Radical hysterectomy

In radical hysterectomy, the surgeon removes the uterus, cervix, tissues on both sides of the cervix, and including the upper part of the vagina. This type of procedure is most often recommended to treat cervical or uterine cancer.

Total hysterectomy with bilateral salpingo-oophorectomy

In 50% of cases, hysterectomy also involves oophorectomy (removal of one ovary) or bilateral oophorectomy (removal of both ovaries). The purpose of oophorectomy is to reduce the risk or prevent ovarian pathologies and cancer.

Thus, total hysterectomy with salpingo-oophorectomy involves the removal of the uterus, cervix, fallopian tubes (salpingectomy) and ovaries (oophorectomy).

How hysterectomy is performed

Hysterectomy surgery is usually performed under general anesthesia and takes between 1 and 3 hours. This means that you will be unconscious during the procedure, connected to machines that will monitor your heart activity.

It is also possible to opt for regional (or epidural) anesthesia only, so that you are aware but do not feel pain during the operation.

To remove the uterus and, as the case may be, the organs in the uterine region, the doctor can have several approaches:

Vaginal hysterectomy

With vaginal hysterectomy, there will be no external incision. The doctor will remove the uterus through an incision in the vagina, which he will close with absorbable sutures.

It is the procedure with the fastest recovery (up to 4 weeks) and the fewest complications, after which you can go home the same day. Vaginal hysterectomy is usually recommended when there is no cancerous condition (eg in the case of uterine prolapse).

Abdominal hysterectomy

In the case of abdominal hysterectomy, the incision is external, at the level of the abdomen, and is 15 cm to 20 cm in size. The incision can be made vertically (from the umbilical area to the pubic bone), or horizontally, above the pelvis.

Recovery after abdominal hysterectomy takes longer, and you will need a longer hospital stay (2-3 days). Abdominal surgery is recommended when the uterus is enlarged or if you suffer from cancer or diseases that extend to other organs in the pelvic area.

Laparoscopically assisted hysterectomy

To perform a laparoscopic hysterectomy, the doctor makes a small incision through the umbilical area, where he inserts a tube with a camera at the end (laparoscope) into the abdomen. Through other small incisions, other surgical instruments are introduced, with the help of which the uterus can be removed in parts, through the vagina or through the same incisions in the abdomen.

Recovery takes less time than abdominal hysterectomy and is not as painful. Depending on the case, you may return home the same day or you may need to stay in hospital overnight.

Recovery after hysterectomy

The time required for recovery from a hysterectomy varies depending on the type of procedure and the patient, from 4 to 6 weeks. Sometimes you can leave the hospital the same day (in case of vaginal hysterectomy), or after 2-3 days (after abdominal hysterectomy).

After the operation, the medical staff will monitor your condition and make sure that there is no risk of complications (eg bleeding or blood clots) before telling you that you can go home. The doctor will also communicate the prohibitions and recommendations during the recovery period, including avoiding physical exertion and not inserting anything into the vagina. If you have questions about what you are allowed or not allowed to do, now is the time to discuss it with the specialist.

Sex life after hysterectomy

In general, if there are no complications or specific prohibitions from the doctor, you can resume your sex life 6 weeks after the hysterectomy.

If the condition treated by removing the uterus was previously affecting your sexual experience (causing pain or discomfort), the result of the procedure is often an improvement in your intimate life.

On the other hand, there are situations when side effects can decrease the quality of sexual life by:

• Decreased sex drive: The ovaries produce estrogen and testosterone, and their elimination can lead to reduced hormone levels and, automatically, decreased libido. The condition is found in about 20% of women.

• Decreased intensity of orgasms: the uterus and cervix contain nerves that are stimulated during intercourse, and they contribute to reaching orgasm. By removing the uterus and cervix, these nerves are cut. This situation is rare, and most women continue to have orgasms even after a hysterectomy.

• Pain during sex: removal of the ovaries and disappearance of menstruation can cause menopause-like symptoms (eg hot flashes, night sweats, etc.). One of these symptoms can be drying of the vaginal tissue, which is why sex can become painful.

Tips for women who have had a hysterectomy

We recommend that you always follow the advice of the doctor who performed your hysterectomy. He knows your medical history and health best, and can give you the most suitable recommendations for you.

If you have undergone such an operation, here are some general tips:

Another very important thing is to be patient with yourself. Listen to your body and resume your sex life gradually, at your own pace. Avoiding intercourse for 6 weeks is only the minimum recommendation. This should not put pressure on you if at the end of the period you do not feel ready.

Many women associate the absence of a uterus or female reproductive organs with the loss of femininity. Emotionally, this can affect you and even reduce your interest in sex. If you find yourself in this situation, psychological counseling can help you.

Remember that menstruation, the menstrual cycle, and pregnancy are all part of womanhood, but they do NOT define her. Your breasts, uterus, ovaries, and other reproductive organs are part of your journey, but they are not your identity. You are not less of a woman after a hysterectomy, because your femininity lies in many other things: including the strength to recreate yourself, the power to overcome obstacles and your ability to define yourself.

Frequently asked questions about hysterectomy

If you have other questions about recovery and life after hysterectomy, read this section as well. Here are some frequently asked questions from women who have undergone this operation:

What should I expect in the first few weeks after total hysterectomy?

Recovery from hysterectomy usually takes between 4 and 6 weeks. So in the first weeks it is normal to notice:

• Vaginal discharge: Pink or brown discharge for short periods and in small amounts is normal. But if you have vaginal discharge that persists, make a visit to your gynecologist. There can be several causes, about which I told you everything HERE .

• Vaginal bleeding: It is normal to have small amounts of blood in the first few weeks after a hysterectomy. Do not use tampons, but choose natural intimate care products , such as 100% organic cotton pads (protect your intimate flora and do not contain toxic ingredients that cause irritation and itching) and an intimate gel made from natural ingredients for a gentle, fragrance-free cleansing and other irritants. If after 4 weeks you still have bleeding, or if it is heavy, talk to your doctor.

• Itching, stinging, or pain: These symptoms are normal at the incision until the wound heals. Your doctor may prescribe pain relievers or other medications to relieve your symptoms.

When/how soon can I have sex after total abdominal hysterectomy?

The general recommendation is to avoid sexual contact for the first 6 weeks after a hysterectomy. But the waiting time differs from woman to woman, including depending on the state of health, complications and the pace of recovery.

Follow the doctor's instructions regarding the resumption of sexual life. He may also do an ultrasound assessment to confirm if you can safely resume sexual activity.

What complications can occur with hysterectomy?

Like any other surgical intervention, hysterectomy can be followed by certain complications. These include menopause-like symptoms (eg vaginal dryness, hot flashes, etc.) and decreased sex drive.

Other complications can be various infections, weakening of the pelvic muscles, pain during intercourse or decreased pleasure, heavy bleeding, blood clots, urinary incontinence or constipation.

Will I have pain during intercourse after surgery?

In general, if you wait until the period recommended by your doctor has passed, you should not feel pain during intercourse. But if there are complications or if you experience vaginal dryness, sex can be painful. It is recommended that you try different positions and use a lubricant, and if the pain persists, discuss this with your doctor.

Can I still have an orgasm after a total hysterectomy?

For most women, hysterectomy does not affect the ability to feel pleasure or have an orgasm.

But there are also situations in which women say that they can no longer have intense orgasms, or they can no longer have them at all. This happens rarely, and is explained by the fact that removing the uterus and cervix involves cutting certain nerves that are stimulated during sex.

What are the risks of hysterectomy?

Excessive bleeding and uterine prolapse are among the most common risks of hysterectomy. There is also the risk of post-operative infections and damage to organs in the pelvic region (eg blood vessels, intestines, urethra, bladder).

And the anesthesia performed at the same time as the hysterectomy presents certain risks. Some patients have allergic reactions to certain anesthetics or face cardiovascular or respiratory problems. All this should be communicated to the doctor beforehand.