What to Expect After a Hysterectomy, and How to Care for Yourself

Side effects after a hysterectomy depend on the type of surgery you have and how it was done.
Image Credit: Carol Yepes/Moment/GettyImages

While a hysterectomy may sound drastic, this surgery to remove the uterus is actually fairly common: Roughly 500,000 people have hysterectomies each year in the U.S., according to the Office on Women's Health (OWH).

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That makes hysterectomies the second most common type of surgery for Americans assigned female at birth (AFAB), behind only C-sections.

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With that many people undergoing this procedure, it's only natural to wonder what to expect during the recovery process.

"You endured a major surgery, and this takes time to heal from," says Olivia Dziadek, MD, a gynecological surgeon with UTHealth Houston.

Fatigue, pain, spotting, constipation and irritation after urinating are all common, she says. Other post-hysterectomy symptoms may vary depending on the type of surgery you had.

There are three types of hysterectomies: total, partial and radical, according to Johns Hopkins Medicine:

  • A ‌total hysterectomy‌, which is most common, involves removing the uterus and cervix.
  • A ‌partial hysterectomy‌ (also called a supracervical hysterectomy) removes only the uterus and is much less common.
  • A ‌r‌‌adical hysterectomy‌, used only in cervical cancer treatment, is surgery to remove the uterus, cervix and top of the vagina.

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Some people have their ovaries and/or fallopian tubes removed as well; if you do, your recovery may look different.

Recovery time may also vary depending on the kind of surgery used. For example, it can take between four and six weeks to recover from abdominal surgery, according to the OWH, but vaginal, laparoscopic or robotic surgery (sometimes called a da Vinci hysterectomy) may only require three or four weeks of recovery.

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You may need to spend several hours up to several days in the hospital after surgery as part of your initial recovery, depending on the type of procedure you have, according to the American College of Gynecologists and Obstetricians (ACOG).

The remainder of your recovery will take place at home, and you'll need to rest for a period of time before you can resume activities like heavy lifting and strenuous exercise.

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Here, we'll take a deep dive into hysterectomy recovery, with insights about what body changes to expect after uterus removal, the varied emotions that may come up, how to address any discomfort and expert tips on caring for yourself after your surgery.

Initial Hysterectomy Recovery

Here's what to expect in the first few days after surgery, when you're recovering in the hospital.

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Pain

You can expect to be sore in your pelvic area after a hysterectomy, says Suzy Lipinski, MD, an ob-gyn at Pediatrix Medical Group in Denver, Colorado.

"If there are abdominal incisions from an abdominal, robotic or laparoscopic hysterectomy, then those incisions will be sore and your abdominal muscles will be very tender," she says. "It may feel like you did 500 sit-ups during surgery."

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You may need pain medications like acetaminophen or ibuprofen or sometimes stronger options like oxycodone or hydrocodone, Dr. Lipinski says. Pain can also be managed with ice during the first 24 hours, and then heat after that. Your health care team may provide an abdominal binder or support belt to help when you need to be moving around the hospital, Dr. Lipinski says.

Nausea or Vomiting

Nausea and vomiting are common negative reactions to anesthesia, according to UCLA Health.

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"If you are prone to this reaction to anesthesia, then discuss with your anesthesiologist prior to surgery," Dr. Lipinski says. There are medications your doctor can recommend to minimize these side effects, she says. If you do experience nausea and/or vomiting, you might need to stick with the anti-nausea medications during the first few days after surgery.

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Constipation and Gas

It's common to feel gassy after surgery and to experience a bit of constipation, says Latasha N. Murphy, MD, an ob-gyn at Mercy Medical Center in Baltimore, Maryland.

"Since most hysterectomies are now done minimally invasively, the most common side effects are gas pain and bloating for the first three to five days," she says.

If you experience constipation, it can be improved by walking as soon as possible after your surgery, Dr. Murphy says. Walking after surgery is also important because it can prevent blood clots, per the ACOG. Your doctor may also recommend a stool softener to get things moving, and staying hydrated is important, too, Dr. Murphy says.

Vaginal Bleeding

Many people expect bleeding after a hysterectomy, but it should be light and look like spotting, Dr. Murphy says.

That said, sometimes internal stitches may cause bleeding as they dissolve, she says. If you have any bleeding more than spotting and certainly if you have heavy vaginal bleeding, call your doctor or a staff member at the hospital, Dr. Murphy says.

Discomfort With Urination

If your surgery is minimally invasive, your urinary catheter may be removed while you're still under anesthesia. For more complicated procedures, though, your catheter may be removed eight to 24 hours after surgery. The first time you pee afterward, you may feel a burning sensation, but this should get better quickly, Dr. Lipinski says.

"Your doctor will likely check to make sure that you are emptying your bladder adequately," she says. "This can be done by an ultrasound of the bladder after urinating or by a voiding trial with removal of the catheter."

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Managing Stitches

Some people worry about torn internal stitches after hysterectomy, but experts say it's unlikely. "The stitches used internally should absorb over two to six weeks after surgery, and you will not need to do anything with them," Dr. Lipinski says.

Some people notice a small amount of discharge or spotting as the stitches absorb, but most people don't notice any side effects related to internal stitches.

External stitches will likely be absorbable, Dr. Lipinski says. "Stitches can be exposed to air 24 to 48 hours after surgery, and you will want to keep them clean and dry, but no special treatment is necessary," she says. "You may shower normally, but just pat dry and do not scrub or soak the skin incisions until you are cleared to do so by your doctor." (And definitely don't remove your own stitches.)

Long-Term Hysterectomy Recovery

Wondering what to expect in the first three, four, six or even 12 months post-hysterectomy? Keep reading for longer-term symptoms and side effects of hysterectomy recovery.

Hormonal Fluctuations

Many people are concerned with hormonal changes that happen after a hysterectomy, but if you don't have your ovaries removed, you won't have hormonal fluctuations to deal with.

However, if your ovaries are removed, you can expect symptoms, according to the American Society of Anesthesiologists.

"If the ovaries are removed at the time of the hysterectomy, there can be additional side effects," Dr. Murphy says. "These include hot flashes, night sweats, mood changes and weight gain."

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People whose ovaries are removed may benefit from hormone therapy or other non-hormonal medications to help relieve menopausal symptoms and reduce the risk of osteoporosis, according to the ACOG.

Emotional Changes

It's normal to have intense emotions after a hysterectomy, and what those emotions are will vary from one person to another.

Some people may feel sad about the fact that they will no longer be able to carry and birth children. Others may feel validated if the procedure is part of gender-affirming care or relieved not to have to worry about getting pregnant or using birth control.

"These emotional changes are very individual, and there isn't really a 'normal' way to feel," Dr. Lipinski says. "If a patient is experiencing extreme moods, grieving or other negative symptoms, then they should contact their physician."

Sexual Changes

The ACOG recommends waiting at least six weeks after a hysterectomy before resuming sexual activity. Most people don't complain of sexual changes after they are cleared to have sex, Dr. Murphy says.

"A very small percentage of patients may experience pain with deep penetration," she says. "This is usually mitigated by becoming familiar with the upper limit of the vagina and adjusting the depth of penetration."

Vaginal Discharge

What happens to vaginal discharge after a hysterectomy? It depends on what type of surgery you had, Dr. Murphy says.

If your ovaries were not removed, you'll likely continue to have your normal discharge. If your hysterectomy involved the removal of your cervix, you will experience the loss of cervical mucus. If your ovaries were removed, you will experience a noticeable decrease in vaginal discharge and may experience vaginal dryness, Dr. Murphy says.

Make sure to address any vaginal discharge symptoms you are experiencing with your physician, Dr. Dziadek says. "If you have dryness, you may be able to use vaginal estrogen cream in the future," she says.

What About Back Pain?

Although many people worry about back pain after a hysterectomy, they usually experience the opposite, Dr. Murphy says. “Many times, lower back pain is caused by issues with the uterus. Therefore, back pain is almost always relieved shortly after the uterus is removed.”

Tips for Caring for Yourself After a Hysterectomy

It's helpful to understand the bodily changes that happen after a hysterectomy and how to address them. But it's also important to address your own self-care after surgery. Dr. Lipinski shares her top tips for taking good care after a hysterectomy:

  • Give yourself permission to take things slowly. Now isn't the time to have a perfectly clean house or host a big event.
  • Remember each person recovers from a hysterectomy in their own time; one person may be back to work in two weeks, while another may not feel up to it for eight weeks.
  • Ease back into exercise, doing a little light movement or walking each day and only increasing activity when you feel ready and have your doctor's permission.
  • Don't be afraid to back out of plans you made previously if you don't feel up to them yet.
  • Consider tweaking how you sit after a hysterectomy. Having lots of pillows handy, changing positions frequently and not sitting in one place for too long can help.
  • Ask for outside support with household chores from family and friends or professionals as needed, like temporarily hiring a cleaning service or dog walker.

When to See a Doctor About Hysterectomy Side Effects

It's normal to have hysterectomy side effects, including pain, spotting and constipation. Most people recover from a hysterectomy within about six weeks without serious complications. But there are certain signs and symptoms that may require a call to your care team.

"Call your physician if you experience any fever of 100.4 or greater, drainage or bleeding from incision sites, [heavy] vaginal discharge or bleeding or pain not controlled by pain medications prescribed," Dr. Dziadek says.

You should also not hesitate to reach out for support if you have any additional questions about your recovery, including questions about sexual changes, when to resume more vigorous exercise and any unusual mood fluctuations you may be experiencing.

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references

Is this an emergency? If you are experiencing serious medical symptoms, please see the National Library of Medicine’s list of signs you need emergency medical attention or call 911.

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