The Vagina After Hysterectomy: Here’s What to Expect

A hysterectomy refers to the surgical procedure of removing the uterus. About 90% of hysterectomy cases are carried out by choice and not as an emergency procedure.

In most of those cases, the procedure restores health and saves lives. However, just like most major surgeries, it also comes with long-term effects on a woman’s sexuality, life, and health.

A hysterectomy is necessary for treating life-threatening conditions. The list includes severe and uncontrollable pelvic inflammatory disease, serious complications during delivery of baby, and invasive cancer of the reproductive organs. It may also be necessary to control severe uterine bleeding.

Other conditions that may require hysterectomy include:

  • Hyperplasia
  • Uterine prolapse
  • Fibroid tumors
  • Extensive endometriosis

Recovering From Hysterectomy

For a lot of women, having no uterus after surgery means experiencing all the symptoms that caused them to undergo the procedure in the first place. This includes abdominal pain, bleeding, and pelvic pain.

Living life without a uterus can also mean better sex for them. They get to enjoy being intimate with their partner without worry about their symptoms.

However, if the ovaries are removed, there are a couple of challenges you can expect to face.

For example, if your hysterectomy is done before menopause, you’re likely to start experiencing its symptoms. You’ll experience episodes of mood swings and hot flashes as your body starts to adjust to the changes in your hormone levels.

The Vagina After Hysterectomy

Within the first 24 hours after your surgery, you are likely to experience a bit of vaginal bleeding. It should slowly taper off as you heal.

If you feel that your bleeding is getting heavier instead of getting lighter, make sure to call your doctor right away.

Vaginal discharge is also normal after hysterectomy as long as it’s white to off-white in color. It should be odorless and has no other accompanying symptoms.

Take note, however, that the amount of vaginal secretions is likely to be less than when you had a hysterectomy. This is particularly true if your cervix is also removed during surgery.

Hysterectomy is probably one of the major causes of vaginal shortening. The more radical your procedure is, the more stitching and internal trimming are required. These things result in reduced vaginal capacity.

Additionally, the tenderness, swelling, bruising, and inflammation that occur following surgery can make the vagina less elastic. The organ may feel tightly immediately following surgery but it should return to normal after recovery.

If the vagina doesn’t return to its normal state and actual shortening happened, you have the option to have it repaired. The complexity of the procedure will depend on the extent of the surgery.

Some measures to correct vaginal shortening includes biological animal grafts, muscle flaps, skin flaps or the use of your own bowel tissue. While possible, these measures come with a lot of complications so they are considered as last options.

Your doctor will first advise you to try less physically intrusive solutions first, like getting a pelvic floor massage, using vaginal dilators, and undergoing pelvic floor physiotherapy.

Now, in case you feel a heavy pressure in your lower pelvis which makes sitting for a long time a bit uncomfortable, the best solution is to consciously work on relaxing the muscles. That pressure is due to the reactive muscle spasm of your pelvic floor muscles.

If that doesn’t work, you can try applying a heating pad to the area. You can also take pain relievers, like ibuprofen.

About Vaginal Cuffs

After a radical or total hysterectomy, your doctor may create a vaginal cuff. It’s a closure made by stitching together the top part of the vagina.

In some cases, this procedure is done separately. Your doctor may need to assess first the area if there’s improper healing or tearing.

If you had a hysterectomy with a vaginal cuff, your recovery may take at least 6 to 8 weeks. Your overall health will determine your recovery rate.

If your cuff develops scar tissues, your doctor may need to apply a bit of silver nitrate to facilitate healing and remove the said tissues.

Scar removal isn’t really painful but it can be uncomfortable.


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