Please note that this post mentions the mechanics of how the pelvic floor and cervix reacts during an orgasm. For those with sensitive eyes and minds, proceed at your own risk.
Though I have not been as diligent as I had hoped to be, right when I hit the 5 week post-op point, I got a cold that persisted for nearly three weeks. I’m getting over that, but I can say that the two weeks of coughing on my healing pelvic floor was not fun. I also did not have the energy to really work out and improving my cardio and strength. I am now approaching nine weeks post-op from my hysterectomy and had my final follow-up with my surgeon just a few days ago. I will be going over how I’m feeling overall, my appointment with my surgeon, and initiating intimacy again.
Due to the cold that I acquired, I am starting to feel (and sound) more normal. I felt terrible for patients who were seeing me and my voice would vacillate between pre-pubescent boy to one of the RugRats crew to non-existent. It was a fun time, lots of loud whispering. I did not have a lot of energy and mostly kept what energy I had to focus on my patients and a fun getaway to Port Townsend to visit friends on Labor Day weekend. This week I’ve done a couple of yoga sessions, some walks, and more cooking. I also think the changing of the season into Fall makes me want to whip up and freeze soups and other yummy dishes. One of my friends let me scavenge through her family’s garden while they’re away so I’m having fun parsing through garden veggies. My plan is to get back to doing yoga three days a week and maybe some form of dance (in the privacy of my own home to not scare the general public) for cardio until I feel better prepared to start weight lifting. Overall, digestion is still better than before my surgery, including continued more frequent bowel movements but only one instance of constipation- which was likely due to not staying hydrated. I do not have any pelvic pain and my incisions in my abdomen are fully healed.
My follow up with my surgeon went really well (and quickly). The evening before the appointment I spotted just a little, which made me anxious, but it did not last. I was relieved that I was going to see her the following morning. By the morning, there was no more spotting. When I mentioned this, she said it’s likely that one of the sutures was just irritated. She did an internal examination to look at the top of my vagina where my cervix used to be and determined that there was still one suture still there and one other area that looked a little irritated but no abnormal tissue. Things were healed and the suture could take up the 6 months to fully dissolve. If the spotting is to continue for longer than 2 months, I am to follow up with her for another evaluation. I was cleared to resume “all normal activities” but to also be smart about it. One downside is that I was weighed prior to seeing my surgeon and I have apparently gained ~10lbs since the surgery which is unfortunate. I’m not one to obsess over a number on the scale, but I can feel those extra 10lbs on my 5’1” frame and feel uncomfortable in my clothes. Getting back to some workout routine will allow me to feel better in more than one way, but especially in my own clothes.
“All normal activities” also includes sex. Know that I am not writing this as an expose into my private life, but to give a perspective on healing from a hysterectomy in all aspects. One thing I will say is that I have a very loving and understanding boyfriend who respects my boundaries and checks in every time we are intimate. I believe (again, this are my thoughts on my body) that since I still have one suture in place, I did have some discomfort with deeper penetration/thrusts, but not with orgasming. Another thing that felt different is some difficulty feeling my pelvic muscles contract during orgasms. That’s usually not a problem for me, but with the cervix removed, the mechanics of orgasming have changed. With an intact cervix, during orgasm, the pelvic floor muscles contract and the cervix rhythmically convulses, essentially “throwing” semen into the uterus. Weird, but that’s biology. Without the cervix being there and my pelvic floor muscles now sutured in a way that it is not used, the ability to fire and contract was initially limited. Thankfully, the second time felt more normal, but I need to work more on pelvic floor muscle strengthening. I’m sure the two weeks of coughing and minimally engaging my pelvic floor affected things as well.
I consider myself lucky in so many ways, from the success of the surgery, a great surgery team, the ability to have time to heal, and having supportive friends and an understanding partner. I know not all women are so lucky as I have treated those women. Again, I’m always available for questions at email@example.com.
Kathleen Neal, DPT