Getting back to activities like sex after a hysterectomy can be intimidating. 

Learn what a hysterectomy is, how it can affect your sexual function, and what pelvic floor physical and occupational therapy can do to help. 

What is a hysterectomy?

Acording to the American College of Obstetricians and Gynecologists (ACOG), a hysterectomy is surgery to remove the uterus. It is a common type of surgery for women in the United States.

• Hysterectomy is used to treat many women’s health conditions including:
• Uterine fibroids (this is the most common reason for hysterectomy)
• Endometriosis (although it states this on ACOG, it is more correct for this to state Adenomyosis, which is endometriosis in the uterus. Please be clear -- a  hysterectomy is NOT a cure for endometriosis).
• Pelvic support problems (such as uterine prolapse)
• Abnormal uterine bleeding
• Chronic pelvic pain
• Gynecologic cancer

If you’re facing a diagnosis of bladder cancer or a similar health concern, sex may be the last thing on your mind.

However, your sex life after a cystectomy (bladder removal surgery) should be a major consideration for any doctor who recommends it.

Sadly, research shows that’s much more likely to be true for men than it is for women. In fact – although sexual function after bladder removal is ‘routinely considered’ for male patients – surgeons in one study discussed complications that could affect pelvic health and sexual function with just 13% of female patients. Worse, the medical counseling those women got after surgery ignored the topic of sex altogether.

How much do we really learn about intimacy, affection, sensual touching and sex while growing up?

A lot of our references for intimacy come from what we see in our families, movies, and for sex, a lot of the time porn. What we are individually exposed to will possibly become what we think is the norm, which can then possibly skew our views towards intimacy with a partner. For instance, if a woman watches porn for a sex reference she may think her vulva has to look a certain way or that she needs to attain an orgasm with penetration or to be intimate with her partner she has to have sex, when that’s not really the case.