Learning that you need a hysterectomy can bring out all the feelings. On one hand, maybe you’re excited to be getting rid of something in your body causing you pain or bad health. And hey, no more period stress! On the other hand, it’s a big operation, and surgeries can be scary. Some people worry about what the scarring will look like. Knowing what to expect after a hysterectomy can help you calm your nerves and make your recovery as smooth as possible.
Here, Romper speaks with two surgeons who perform hysterectomies day in and day out, and they share exactly what you can expect while recovering from a hysterectomy (including their best tips for healing quickly and comfortably).
Types of hysterectomy
People with uteruses might need a hysterectomy for a wide variety of reasons, like treating fibroids, cancer, or endometriosis, or as part of gender affirmation surgery. Your reason for needing the operation will dictate exactly what kind of hysterectomy you have.
The most common, according to experts, is a total hysterectomy, which removes the uterus and cervix. A partial hysterectomy removes just the uterus, while a radical involves taking out the uterus, cervix, Fallopian tubes, and upper vagina, according to the National Women’s Health Network.
There are also many ways the surgery can be performed. There’s the abdominal hysterectomy, performed through a C-section-like incision about 14 centimeters long just above the pubic hairline. It can be horizontal or vertical.
“In general, patients benefit from minimally invasive hysterectomies, which is anything but the abdominal type,” says Dr. Mary Ellen Wechter, MPH, gynecologist with North Florida Gynecology Specialists and Baptist Health. “The next type is a vaginal hysterectomy, which is the least invasive route. It’s done through the vagina with no incision on the belly. Then, laparoscopic hysterectomies are where there’s an incision in your belly button and about three to four other incisions on the belly and we operate using long, skinny instruments. And a robotic hysterectomy is an advanced technological version of a laparoscopic hysterectomy that allows a more delicate procedure.”
How long does it take for hysterectomy to heal?
Your recovery timeline depends on which type of hysterectomy you’ve had, experts say. “Open surgery typically requires four to six weeks of recovery. Laparoscopic and vaginal surgery typically require one to two weeks of recovery,” says Dr. Louise Perkins King, JD, OB-GYN at Brigham and Women’s Hospital and assistant professor at Harvard Medical School. “Minimally invasive surgery has a wide variety of responses, but typically you’re sent home the same day and are back to work in a maximum of two weeks.”
And how long can you expect it to take for your incision to heal? The skin may appear healed, but Wechter says the fascia below (the strong tissue layer that holds in your organs) takes about six weeks to repair itself. Lifting or straining before then could lead to a hernia through one of your incisions.
In the first couple of weeks, here’s how Wechter recommends you keep the surgical site clean: “The largest incision is generally in the belly button, and that’s the one that hurts the most and is most at-risk for hernia or infection because it's deep and dark. You can shower 24 hours after surgery, so I have folks take two Q-tips, rub them on a bar of Dial soap (because it’s antibacterial), and swirl it in the belly button to give it a good wash. Rinse it really well. It doesn't hurt to put ointment over the incision, like Neosporin or Vaseline even. It seems to help the skin edges migrate together.”
How long does pain last after a hysterectomy?
It’s natural to be nervous about pain post-surgery. If you have an open hysterectomy, you’ll stay in the hospital one or two nights so they can manage your pain levels. King and Wechter agree that patients who have minimally invasive procedures tend not to have much pain at all.
“Pain wise, most people need very little narcotics after surgery,” says Wechter. “The trick is to take pain medication like Tylenol and ibuprofen around the clock on a schedule for the first couple days. Maintaining pain control works way better than chasing pain that’s out of control. Set your timer and take them every six hours to stay on top of it.”
The pain gets better daily, Wechter says. “By the first week people feel pretty darn good. By three weeks, people have almost no pain. By six weeks, people are back to most of their normal activities.”
When can you have sex after hysterectomy?
If your doctor hasn’t told you yet, here’s the bad news: anyone recovering from a hysterectomy is going to have to take a few months’ sabbatical from any bedroom shenanigans. It’s for a good reason though.
“For most people, we have them avoid intercourse for six to 12 weeks,” says Wechter. “Hysterectomies that are complete, meaning we remove the uterus and cervix, have an incision in the vagina. I err on the side of 12 weeks because even if it should be healed, that area can take a lot of pressure during sex.”
Dos and don’ts after hysterectomy
If you don’t have a pal who’s been down this road and can give you some hysterectomy recovery tips, here’s the DL on getting through the next few weeks as comfortably as possible.
- Take it easy, tiger. “At least those first three weeks, move kind of like an 80-year-old,” says Wechter. “You can be up and moving around — think like an 80-year-old who’s doing her thing, not a sick 80-year-old – but no bouncing up and down the steps. A lot of fast walking moves the inside tissue of the vagina and can pull on that internal stitch line, and if it’s moving constantly, it doesn’t heal as strongly.”
- Get moving when you’re able. “Remind yourself to get up and move around to keep passing gas and keep from getting a blood clot,” Wechter says.
- Keep your stool softeners handy. “The bowels get paralyzed during surgery with all the other muscles and are a little slow to wake up. Take a stool softener twice a day after surgery and get right on something like Miralax or Dulcolax the morning after to get the bowels moving,” Wechter says.
- Protect your incision. “For larger incisions, we try not to have anything rub on it. Take a maxi pad and turn it soft side in and stick the adhesive side to your underwear so they’re not rubbing the incision,” Wechter says.
- Sit up and stand up carefully. “The main thing is not to use the belly as much as possible and strain those incisions,” Wechter says. “You don’t want to get a hernia. Have someone kind of pull on your hands to help you stand up. When getting out of bed, roll to your side and push up with the opposite arm.”
- If you have pain in unexpected places, don’t panic. “The pelvic floor can sometimes spasm and feel heavy — the muscles that were holding up the pelvic organs are strained and pushed on during surgery. Sitting in a warm bath will help with that,” says Wechter. “Shoulder pains are really common, and they’re actually caused by diaphragm irritation. It’s called referred pain. Maybe there’s gas in the bowel or blood under the diaphragm, and the nerves from the diaphragm are read by the brain as coming from the shoulder, so you’ll feel the irritation there.”
If at any time you notice anything strange about your incision, swelling around your legs, or have a sudden gush of fluid after intercourse, you should call your doctor right away. But rest assured, complications after a hysterectomy are very rare. Just get comfortable on that couch, queue up a new Netflix series, and let your body heal.
Dr. Louise Perkins King, JD, OB-GYN at Brigham and Women’s Hospital and assistant professor at Harvard Medical School
Dr. Mary Ellen Wechter, MPH, gynecologist with North Florida Gynecology Specialists and Baptist Health