Hysterectomy: life after surgery

A hysterectomy is the surgical removal of the womb (uterus). According to the NHS, 30,000 hysterectomies are carried out each year in the UK. 

You may have been offered a hysterectomy if you have health problems that affect your reproductive system. Once you have a hysterectomy, you will no longer have periods and will not be able to have children. 

There are different types of hysterectomy, depending on how much of your womb and reproductive system needs to be removed:

• Radical hysterectomy — the womb, cervix (neck of the womb), some parts of the vagina and surrounding ligaments are removed
• Total hysterectomy — the womb and cervix are removed
• Subtotal hysterectomy — the main body of the womb is removed

Your hysterectomy can be performed in different ways and your consultant will discuss which is most suitable for you. You may have an:

• Abdominal hysterectomy — your womb is removed through a cut in your lower abdomen
• Laparoscopic hysterectomy — your womb is removed through small cuts in your abdomen
• Vaginal hysterectomy — your womb is removed through your vagina

What are the side effects of a hysterectomy?

It’s important to remember that a hysterectomy is a major operation and carries a risk of complications, as all surgeries do. This includes infection, heavy bleeding and damage to your bladder or bowel. 

Side effects can affect both your physical and mental health.

Physical side effects

After a hysterectomy, it is common to experience physical side effects such as:

Bladder disturbances 

Some women find they develop urinary tract infections (UTIs) after their surgery. These are normally easily treated with an antibiotic prescription from your GP. Make sure you drink plenty of fluids after your surgery to minimise your chances of developing a UTI.

Bleeding 

Vaginal bleeding after a hysterectomy is normal and may last up to six weeks. However, if you experience heavy bleeding or start passing clots, contact your GP.

Constipation 

Some women experience constipation either as a side effect of surgery, or taking painkillers. Drink plenty of fluid and eat a high-fibre diet with plenty of fresh fruit. Talk to your consultant about taking laxatives for the first few days after surgery; these will help stop you from straining when passing a stool.

Pain ­

During your recovery, you may experience some pain, including around the wound site. If over-the-counter painkillers aren’t effective, your GP can prescribe you stronger pain medication.

Vaginal discharge 

It is normal to experience vaginal discharge for up to six weeks after a hysterectomy. You may therefore need to wear sanitary pads, which will also allow you to monitor your discharge. Discharge should not be heavy or have a strong smell — talk to your GP if you experience either of these. 

Emotional side effects

Having a hysterectomy is a big adjustment for many women. Some feel a sense of loss or grief as they are no longer able to get pregnant. This can be hard to process despite the benefits gained from the surgery. 

Research suggests that having a hysterectomy is associated with an increased risk of mental health issues, such as depression. It is therefore important to talk about your feelings either with a loved one or with your GP. It’s also important to remember that you’re not alone. Many women have similar emotional experiences before and after their surgery and it’s natural to feel anxious or sad. Look online or in your local media for support groups — there are websites and forums dedicated to supporting women through their hysterectomy.

If you feel that you may be depressed, contact your GP. They will be able to provide you with a support system and treatment options. 

Life after a hysterectomy

Typically, it will take around six to eight weeks to recover from an abdominal hysterectomy and around three to four weeks to recover from a vaginal or laparoscopic hysterectomy.

You will need to: 

• Avoid lifting — your abdominal muscles need to heal
• Avoid wearing tight clothing
• Check your wound for signs of infection 
• Not drive for at least two weeks 
• Not have sex for at least six weeks
• Get plenty of rest

You will have a follow-up appointment around four weeks after your surgery. You should be able to return to work between four and eight weeks after surgery, depending on what it is that you do. Once your doctor says it is safe to do so, you can start gentle exercise. 

After your hysterectomy, you should have a better quality of life as you will have relief from the symptoms you had before surgery. 

However, if you also had your ovaries removed during your surgery and consequently go into menopause, you may experience a reduced sex drive, vaginal dryness and/or discomfort during sex. If you experience any of these symptoms, talk to your partner so you can work together on a solution, such as trying a water-based lubricant to help with vaginal dryness.