Even though you will have the okay to have sex about 6 weeks after surgery, it may take a few months before sex can be enjoyed. This may be because the abdomen may feel bruised or sore and the vagina may have shrunk. Uncomfortable intercourse can also be a result of vaginal dryness that can be a result of a deficiency of estrogen. This is a common occurrence when the ovaries are removed. Some ways to help increase pleasure during intercourse can be through:
-using erotic reading, pictures, films, change of location, dancing and activities that physically move the pelvic area
more effort in intercourse to push the penis hard against the far end of the vagina in order to stimulate the peritoneum. Deep penetration is helped by the female-astride position or the man-on-top position with the woman's legs on the man's shoulders and pillows under her hips
use of coconut oil or K-Y jelly to lubricate the clitoris and vagina
more experimentation with oral sex or delicate manipulation of the clitoris
learning to use penetration with fingers first to prepare for intercourse with a penis. This helps lubrication occur more rapidly
try using a new pace. Move slower and respect the fact that stimulation may take longer
After having a hysterectomy, it is extremely important to talk with your spouse and communicate what you are going through. Sharing this information will help your partner understand your physical and emotional needs.
Estrogen Replacement Therapy
It is very important to have a healthy diet and exercise after surgery. As well, estrogen replacement therapy (ERT) can help to control some of the symptoms that usually accompany a hysterectomy. This therapy is especially important for women who have had an oophorectomy (removal of the ovaries and fallopian tubes). The removal of the ovaries before menopause can result in your body experiencing a rapid decline in sex-hormone levels which can result in an instant onset of menopause. Due to the loss of estrogen, many women experience menopausal symptoms, such as hot flashes, night sweats and vaginal dryness. These symptoms can begin as soon as one to two days after surgery and can last longer than the symptoms of natural menopause.
Taking ERT in order to replace estrogen that your body cannot otherwise produce can help to alleviate hot flashes, drying and shrinking of the reproductive structures. This can work to avoid and relieve related problems such as vaginal irritation, painful intercourse and difficulty or burning during urination. It is important to discuss the effects of ERT with your doctor if you have ever had cancer of the breast, uterus, unusual vaginal bleeding, abnormal blood clotting or any heart disease. Taking estrogen, can also help to prevent osteoporosis, the loss and deterioration of bone.
Some women should not engage in ERT. It is always important to discuss your medical history with your physician and the risks that are involved. It is still being researched whether or not breast cancer risk is increased with the taking of estrogen. Some studies show an increased risk in breast cancer with women who take high doses of estrogen for long periods of time. Make sure that your doctor is aware of the following conditions if you have them; high blood pressure, kidney disease, asthma, skin allergy, epilepsy, migraine headache, diabetes, and depression. Some of the side effects that you may experience with taking estrogen are nausea, fluid retention, irregular bleeding and breast tenderness.
Forms of Estrogen
Tablets-The most common type of oral estrogens are conjugated equine estrogen. Tablets are generally taken daily for the number of days indicated by the prescribing doctor.
Injections-For some women, injections will be better suited for them. The injected estrogens are slowly absorbed and circulated through the body over extended periods of time. The injections usually go right into the blood stream rather than through the stomach and liver. Injections are usually given by your physician once every 3-4 weeks.
Transdermal estrogen- This is a Transdermal patch, placed on the skin. It is a new way to take estrogen for the treatment of menopausal symptoms and prevent postmenopausal osteoporosis. It is a small, clear, self-adhesive patch that contains a quantity of estradiol, which is identical to the hormone made by the ovaries. It is released at a relatively constant rate through the porous membrane at the base of the patch. The estradiol travels through tiny blood vessels near the skin's surface and enters the circulatory system. Once it has entered the bloodstream, the estrogen is ready for the organs that need it.
Some users of the patch may experience some sort of irritation around that area of skin. It usually disappears within a few days removal of the patch. When using Transdermal estrogen, it should be changed twice a week. Every new patch that is put on should be placed in a different skin site.
Complications
Sometimes after surgery there can be some complications. Being aware of them can help you with preventing them from happening. Some things to watch out for are:
1.Infection-Most infections can be treated successfully with antibiotics, but some infections can be severe. Many surgeons now order antibiotics routinely before surgery. It is also important after surgery to not place anything in the vagina for at least the first 4 weeks. This includes intercourse, tampons, douching, swimming, and baths.
2.Urinary tract complications-Almost half of the women who have hysterectomies will have a kidney or bladder infection following surgery. In most cases the problem is not serious. In a radical hysterectomy, sensory nerves may be cut (sometimes unnecessarily) and women can lose both the sensation of having to urinate and control over bladder functions.
3.Hemorrhage-More than one in ten women require transfusions, some due to undetected preexisting anemia.