Hysterectomies and mastectomies are extensive surgeries, and sex should only be resumed when a woman is physically and mentally ready to do so. While a mastectomy doesn't affect a woman's ability to have sex, cancer treatment may affect sexual desire and arousal. A hysterectomy will affect a woman sexually in the short term, as pain and bleeding are common. Intimacy can be maintained throughout both procedures.
Sex and intimacy after a hysterectomy
A hysterectomy is the complete or partial removal of the uterus and sometimes the cervix, fallopian tubes, or ovaries. This surgery is normally done to treat gynecological cancers, fibroids, endometriosis, or heavy periods.
Women having this surgery will no longer have their period, and women who have both ovaries removed immediately begin menopause. This can impact sex and intimacy in the short and long term.
When is it safe to have sex again?
It is best to wait six weeks after surgery until the bleeding and pain have stopped before commencing sexual activity. This may change on an individual basis, so it is best to get a doctor's approval before inserting anything into the vagina.
A hysterectomy is a big surgery that will affect each woman individually. It is important that a woman takes her time and only explore sex and intimacy when she is ready to do so.
Changes in sexual functioning
Women who have undergone a hysterectomy often report a decrease in their sexual desire and arousal. During the sexual response cycle, the uterus changes positions, becomes engorged, and contracts during orgasm, creating sensations that can not be felt after a hysterectomy. Other women experience changes in sensations due to damage to the nerves in the pelvic region from surgery.
Women who have their ovaries removed may also experience a lack of desire, arousal, and vaginal lubrication due to the absence of testosterone and estrogen. The ovaries produce these hormones and are responsible for a woman's libido. Women who have had their ovaries removed alongside their uterus may be given hormones to help alleviate the symptoms of menopause, and this may also help to reduce the loss of arousal and desire.
However, studies have found that many women report an improvement in their sexual satisfaction as a result of the surgery, as it alleviates the pain or bleeding they were experiencing prior to surgery and alleviates stress from unwanted pregnancy. Many women continue to experience orgasms after a hysterectomy as the functioning of the clitoris is not affected.
Removing the uterus and surrounding organs is a significant life event that puts women at a higher risk of depression. Many become sad and anxious, particularly those mourning the loss of their fertility. Women who have their ovaries removed may become irritable due to the drop in testosterone and estrogen. Additionally, some women report a change in their self-image, as the loss of their uterus is seen as the loss of femininity. Addressing these issues will help women return to normal sexual functioning.
Sex and intimacy after a mastectomy
A mastectomy is the removal of the breast and is done as a method to treat or prevent breast cancer.
When is it safe to have sex again?
It is safe to have sex at any time during a mastectomy. However, the effects of chemotherapy, radiation and pain from the surgery may adversely affect a woman's desire to do so. A woman should take as much time as she needs and only explore sex and intimacy when ready.
Changes in sexual functioning
For many women, the breasts and nipples are an important part of sex. Women may gain pleasure from having their breasts fondled, licked, or sucked, and the absence of this pleasure may take some time to get used to. This may also be present in women who have had reconstructive surgery.
Women may also feel a decrease in sexual desire or arousal due to the changes in their bodies. Some women are afraid to be touched or show their partner their breasts as they are self-conscious about how they look or the scarring. Cancer treatment can also affect desire and arousal.
Like the effects of a hysterectomy, the removal of the breasts can cause women to feel a loss of femininity, as the breasts symbolize femininity in many cultures and are integral to a woman's identity. This is also true for the hair loss many women experience during treatment for breast cancer. Both the removal of the breasts and hair loss have been found to cause depression for some women with breast cancer. Additionally, the uncertainty of a cancer diagnosis and the financial stress often experienced brings anxiety to many women. These emotional effects can damper a woman's desire and arousal and should be addressed to regain normal sexual functioning.
Tips to restore sex and intimacy after surgery
Take your time
Having a hysterectomy or mastectomy is a big change, not only physically but mentally. It will take some time for your body to repair from the surgery and for you to adjust to your new body. The time it takes to heal and feel like yourself again is different for every woman. Allowing for time gives your body the ability to become aroused naturally.
Explore your body
When you are ready, take some time to explore your body post-surgery. How you like to be touched may have changed, so grab a vibrator or your fingers and some lubrication to find what feels good.
If having sex with a partner, you may need to get curious and explore new ways to have sex by trying different positions or forms of sex, like oral.
Communicate your needs with your partner
It is essential to communicate your needs to your partner during this time. Be open to them about what feels good to you and what doesn't.
If you feel as though you are distressed about your lack of desire or intimacy or are feeling down as a result of the procedure, seek help from a mental health professional.
Surgeries such as hysterectomies and mastectomies can take a massive toll on the body physically and mentally, leading to lower sexual desire and arousal and decreased body image. If you have undergone one of these surgeries, it's important that you take the time to heal physically and emotionally before resuming sex and be open to exploring different types of sex to find new ways of intimacy.
As the uterus and ovaries play an important part in the sexual response cycle, their removal may decrease arousal and desire in women. However, many women report having increased sexual satisfaction after a hysterectomy.
The breasts are symbols of femininity, and many women suffer a loss of identity after their removal. For women who gain pleasure from breast stimulation, the loss of the breasts can be upsetting.
Exploring the body sexually post-surgery can help a woman identify what feels good, which can then be communicated to a partner.
Is the Uterus a Sexual Organ? Sexual Function Following Hysterectomy - Sexual Medicine Reviews
Hysterectomies Are Associated with an Increased Risk of Depression: A Population-Based Cohort Study - Journal of Clinical Medicine
Body Image of Women with Breast Cancer After Mastectomy: A Qualitative Research - The Journal of Breast Health
The Relationship Between Anxiety, Depression and Self-Esteem In Women With Breast Cancer After Surgery - Procedia - Social and Behavioral Sciences