6 tips for sex after a hysterectomy

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In 2014 I was diagnosed with inflammatory myofibroblastomic tumours in my uterus (a rare form of womb cancer). In June this year I had a total hysterectomy, and have been recovering my life ever since.

Before my hysterectomy I was put on a hormone treatment (zoladex) for 4 months which was unfortunately unsuccessful. This plummeted me into an induced menopause. I  suffered with low moods, hot flushes and the dreaded vaginal dryness. At this point it was decided the only option I had left was a total hysterectomy and within the month I was on the surgeons table.

The hysterectomy was performed laparoscopically, where cameras as well as surgical instruments were used to remove my womb and cervix through my vagina. My vagina was then sutured and the fallopian tubes disconnected to preserve my ovaries. Full recovery takes between 12-18 months, but about 6 weeks post surgery I was feeling healthy and back to normal activity levels (almost). Having a hysterectomy affects you in many ways, my confidence and trust in my body’s ability was questioned, making it  hard to know when to take up/give a miss to different activities. One of the areas this is most profound is sex.

Getting back into sex after gynaecological cancer can be daunting. It is easy to worry about disturbing your stitches, creating damage and holding up your recovery. There is also the fear of pain or bleeding, which can be embarrassing and hard to deal with. Even after recovery, scar tissue is inflexible which can cause discomfort or pain during sex. From experience, I found a lack of information on how to safely and enjoyably get back into sex post surgery. The information that is available is predominantly for heterosexual couples. I am single and have, for the most part, muddled through following my instincts. There is no quick fix or one perfect answer that will suit everyone. We are all different but here some things I have learned along the way that helped me (and hopefully you too).

  • Listen to your body: It is so important to listen to your body and take it’s lead. If you don’t feel ready to jump back on the horse quite yet, then you probably aren’t. Likewise if you feel well and recovered, maybe it is time to start slowly introducing sex back into your life. Not having a cervix does make sex feel different, my oncologist warned me of this, and it is certainly true. I wouldn’t say its better or worse, just different. Be aware of how you are feeling and if you have any tension or anxiety about having sex again. You do need to be more aware of how you feel during sex and whether anything is uncomfortable/ painful, or if you notice any blood. Knowing what feels normal or different for you will help you make sure you are going at a pace that is right for you.
  • Seek advice: It may seem uncomfortable to talk about sex but it is important when recovering from a gynaecological cancer. Do ask your doctor about when is safe to have sex again and what you should expect and look out for. Luckily my consultant is fantastic and I am happy to talk to him about anything (considering he has seen my vagina, I don’t have too much left to hide). Just make sure you seek advice from someone informed and reliable.
  • Slow and steady wins the race: Your body has changed, and it is probably still healing, you need to treat it with respect and take things slowly. Start with non-penetrative sex to ease yourself back in and move to penetrative only when you feel ready. Smaller sex toys can also be a great ‘test run’, and seeing what is comfortable for you in a way that is easily controlled.  There are plenty of ways to enjoy your sex life post hysterectomy so look at options that will work for you with how you are feeling (with or without a partner).
  • Stand up for your body: It is hard as a single person when having sex for the first time after surgery. The person you are with might not know much about your situation and talking about it can be scary and embarrassing, but to some extent, you must. Know what you are and aren’t comfortable with discussing, find what works for you. Think about what is within your comfort zone but gets enough information across to ensure you can navigate the situation in a safe and enjoyable way. At the least, make sure the other person knows that you have to take things slowly and that they need to be careful. Even just saying you have had surgery recently is enough to make the situation work without having to bare your life story.
  • Trust: Trust in yourself, your body and your partner. It may seem silly to say, as you should always have sex in a situation where you can completely trust yourself and your partner but after a any gynaecological surgery it is even more important. If you are in a loving long term relationship then you should be in a good position where your partner knows what you have been through and cares about keeping you safe. Yet they might not be fully informed on the impact of your treatment or surgery, and what it means for your sex life. So make sure you are both well informed and on the same page. If you are single, one of my best decisions I made post surgery was for the first time sleeping with someone I knew and trusted. It was all together a relaxed, enjoyable and safe experience. I appreciate this might not be realistic for everyone, but make sure you are with someone you trust to have your wellbeing as a priority and who you can be open with throughout the experience.
  • Be confident: Even though it can be scary talking about something so personal and often painful about yourself, it will help you have complete control over the situation. Be confident in yourself and take the lead on what is working and what isn’t. If something feels uncomfortable, then let your partner know and try something else. Talking about your situation may seem scary at first, but will be worth it when your worry and apprehension is relieved and you have an enjoyable and fun experience.
  • Practice makes perfect

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