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Caz Killjoy’s Tips for Total Hysterectomy Recovery

(Note: a total hysterectomy does not include ovaries – it includes only the uterus and cervix; this resource does not include tips for removal of the ovaries, which is called an oophorectomy. Please consult your medical care team if you are having your ovaries removed.)

I had a total hysterectomy (removal of the uterus and cervix) with salpingectomy (removal of the fallopian tubes) in February of 2018. My surgery was done both vaginally and laparoscopically. I didn’t know what to expect or what I would need at home to help me get through recovery. While there were and are forums and some articles that discuss these needs, I’ve found some sources to be more reliable than others.

Because of my personal experience and my time spent as a sex educator, I’ve had several folks ask me for tips or guidance for their own hysterectomies – so I wrote this! I’ve tried to include everything I can remember that helped me through my own hysterectomy (and subsequent pelvic prolapse correction surgery in 2020).

Please note that this resource is not all-inclusive under all circumstances. Some of these recommendations are not appropriate for certain bodies and disabilities. I’ve tried to factor in some disabilities, hysterectomies for non-cis women, and other considerations, but I’ve definitely not encompassed the full scope of these topics. Additionally, this resource recommends many products, most of which have to be purchased, or if possible, borrowed – I recognize this is a problem because not everyone has the financial resources to make these purchases or the social networks to source the loan of these products. Despite these limitations, I hope this resource will be helpful for some people who may be considering or having a hysterectomy.

Good luck and speedy recovery!

Diet and Avoiding Constipation

The pain medication given during and after surgery causes constipation. As such, the body has a very difficult time moving its bowels after surgery. You’ll want to do everything possible to avoid constipation as straining post-surgery can loosen sutures or stitches, cause bleeding, and contribute to pelvic organ prolapse, which is a risk with hysterectomies.

  • If you don’t already use one and it’s physically appropriate for you, try a bathroom toilet stool ↗ for proper posture when having a bowel movement. It really helps!
  • If you were on a medical diet or receiving liquid nutrition prior to your surgery, check with your care team about what your diet should be like post-surgery. If those circumstances don’t apply to you, you’ll want to have a fiber-rich, soft food diet until you’re off pain meds and successfully moving your bowels without pain or straining. I have two cookbooks that I swear by for this purpose. Every recipe can be made in advance and frozen and then either eaten as a popsicle or thawed out. Ignore that they are “baby foods.” The cookbooks are “Around the World in 80 Purees: Easy Recipes for Global Baby Food ↗” by Leena Saini and “Sneaky Blends: Supercharge Your Health with More Than 100 Recipes Using The Power of Purees ↗” by Missy Chase Lapine. There are a ton of “make your own baby food” books and sites now, so you could also go with other options that might seem more appealing.
  • If you aren’t up for making batches of purees, buy baby food in bulk. Baby food is expensive, and remember, as an adult you’ll generally want to eat more than one container at a time! For this purpose, I recommend making use of a wholesale club membership (BJ’s, Costco, Sam’s Club) if you have access to one. I prefer the baby food brand Beech-Nut ↗ because the items are available in glass jars, which are better for the environment (baby food pouches are generally non-recyclable). However, Beech-Nut also has pouches, if that’s more to your liking. 
  • To help get and keep your digestion moving, try the herb senna, a natural laxative. Traditional Medicinals offer a line of senna products called “Smooth Move.” They come as teas (Original Senna ↗, Senna Chamomile ↗, and Senna Peppermint ↗) and capsules ↗. Check with your care team prior to surgery to find out if senna is an appropriate choice for your body.
  • Senna alone isn’t strong enough for every person. If Senna isn’t enough for your needs, as it wasn’t for mine, Colace 2-in-1 ↗, which combines docusate sodium (a stool softener) with sennosides (the active ingredient in senna), might be for you. Check with your care team prior to surgery to find out if docusate with senna is an appropriate choice for your body.
  • If you still can’t have a bowel movement, speak with your surgical care team. They may recommend a stronger laxative or even a prescription such as Amitiza ↗ (generic name: lubiprostone).
  • For the above reasons as well as just general body recovery, you’ll need to stay well-hydrated. Lots of water is good but if you can add nutrients to all that water, even better. I swear by Nuun tablets ↗ (which you put in the water and wait for them to dissolve) and Kencko ↗ mixes (which are like watered down smoothies; they provide a powdered blend, to which you add water and shake).
  • This tip only applies to you if you were able to safely walk before your surgery; if you weren’t, skip this. You’ll be greatly limited in activity after your surgery, but if you’re able to walk (without carrying anything, squatting, crouching, or bending), doing so is very good for you during your recovery! This low-impact exercise helps to improve sleep, mood, digestion, and will help in keeping your strength up. Try starting by walking the length of your home, then the length of your home a few times; gradually work your way up to walking longer distances. A treadmill ↗ (I use a slim, motorized model that can be folded flat for storage) can be great for this, as can walking the length of a long hallway, a walking track ↗, or a flat walking path.

Mobility Support

This section presumes you had a certain level of physical mobility pre-surgery. If you didn’t, you might already be following these tips – if so, keep them up! Ask your care team what might be right for you if your mobility was limited pre-surgery.

Moving around post-surgery, especially in the first few days, can be very challenging for everyone due to the strain on your abdomen via your pelvic muscles, as well as recovery from intubation and anesthesia. I recommend the below for assistance (and safety!) with movement.

  • A mini step stool with a railing ↗ to help get in and out of bed and to use any time you might otherwise raise yourself on your tiptoes (such as to reach an overhead shelf). Be sure to check the weight-bearing limit of any stool before you buy it.
  • A swivel seat cushion ↗ for transportation in a vehicle. This helps you move your body in and out of your seat. Check what type of seat you have before buying a swivel seat cushion as not all cushions will work with all forms of seats (for example, some won’t work with bucket seating). Be sure to check the weight-bearing limit of any cushion before you buy it.
  • A raised toilet seat with removable padded arms ↗; this is not a commode but a thing that goes over your existing toilet. We don’t know how much we need our core muscles to sit down and get up from a toilet until those muscles have become overly strained! This product raises the height of your seat and provides support bars to help you lower and lift yourself, making it easier to physically get on and off the toilet. Be sure to check the weight-bearing limit of any elevated toilet seat before you buy it; also make sure to check that it is compatible with your toilet (small, standard, or elongated) size.
  • A bed assist bar ↗ that slips under the mattress/box spring or under the couch cushions to help get out of bed and off the couch. Make sure to measure your furniture before purchasing one of these! I have a tall bed and the bed assist bar I originally bought did not fit under my mattress. Be sure to check the weight-bearing limit of any bed assist bar before you buy it.
  • A “bed ladder assist ↗” that works horizontally; it secures under the mattress and then the rungs are used to help sit upright; crucial in the first few days post-surgery.
  • Support bars ↗ (also known as grab bars) on the walls in your shower or bathtub. The suction cup grab bars are safe to use as long as you install them properly! Read the instructions that come with your bars. Include a safety rail ↗ for the side of your tub if you have a bathtub. Don’t forget to read up on the best places to put your support bars ↗ – spacing is important!

Hygiene

Hygiene is very important post-surgery to help cut back on the chance of infection. That being said, keeping up with your hygiene after hysterectomy can be a challenge due to pain, fatigue, and lack of mobility. Below are some items that helped me maintain my hygiene during my recovery period. I still use some of these items years after my surgery because I find them to be very useful!

  • A bidet, even a cheap attachment one. You’ll have to make certain the kind you are getting is compatible with your toilet; if you have a smaller toilet, bidet seats and attachments like Tushy ↗ won’t fit and you’ll have to get a handheld bidet sprayer ↗. If you don’t know much about toilets, asking someone more knowledgeable will help you figure out what type of bidet will be compatible with your toilet! If you own your home, you might want to call a plumber. If you rent your home, you might want to ask maintenance if they will do the installation for you (my landlord preferred that their own maintenance did the install to make certain I didn’t make a mess of things). Note that if you get the handheld kind, someone should toggle it on and off for you during the first few weeks to a month, depending on how you are feeling; this is because to toggle it on you will have to twist your abdomen to the side to reach the toggle – and that can be too painful after surgery!
  • If you can’t afford a bidet or can’t find one that will work for your toilet, you can also get a bidet-like squirt bottle ↗, known as a peri bottle or a postpartum bottle. I swear by my bottle! It can travel with you wherever you go and it’s easy to use.
  • Bath or shower stool, bench, or chair ↗ for the shower or bath. As you won’t be able to submerge yourself in a bath for a few weeks after hysterectomy, you’ll have to stand to shower to bathe. But in the first week or so post-surgery, you might have difficulty standing due to lightheadedness (particularly from pain medication) and fatigue. Using a bath or shower stool, bench, or chair while bathing will help support you while you bathe.
  • A detachable showerhead ↗ (for bath or shower) will help you bathe while seated. Using just a shower head attached to a wall or just the faucet in a bathtub are very difficult when you’re located several feet away from the water source. Using a detachable showerhead will allow you to target the water flow directly where you need it. Please remember not to use the water from the showerhead to douche, and only apply soap or body wash to the outside of the vulva – don’t let it get near your vagina. The vagina is self-cleaning and soap or body wash will change the pH of your vagina in a way that will hinder healing.
  • In the first several days post-surgery, you may feel very sore all over! This can make bathing difficult, particularly reaching your back, legs, and feet. Use a long handled shower/bath sponge ↗ to help make bathing easier.
  • For the first few days of recovery, you’ll likely bleed a bit (the amount will vary as all bodies are different), so you’ll want to make sure you have menstrual pads ↗, preferably cloth.

Pain Management

You will be in pain after your surgery, though the amount of pain experienced varies person to person. Make sure to follow your surgeon’s or pain management’s dosage schedule for your pain medication. In addition to taking my prescribed pain medication, here are some things that greatly helped me manage my pain after my hysterectomy.

  • After surgery, your lower abdomen may feel very sore. With your doctor’s approval, use of a heating pad may be very helpful for this pain. You can choose between a heating pad that provides dry heat and one that provides moist heat; while moist heat can provide more pain relief, they can aggravate some bodies, so the choice between the two types is up to you. There are many types of heating pads, including reheatable heating pads that warm in the microwave ↗, hot water bottles ↗ (don’t forget to use a cloth cover on these and choose a thermoplastic one instead of a rubber one if you have a rubber allergy!), and electric heating pads ↗. Remember, never fall asleep with an electric heating pad on you – you may burn yourself!
  • If you’re prone to digestive or respiratory issues pre-hysterectomy, or just want extra support in sitting up from lying down in bed, try a bed wedge cushion. You likely won’t want one as “tall” as a “sex pillow” (such as the Ramp ↗ by Liberator), so check out this folding bed wedge cushion ↗ from Contour Living, which is made of polyfoam. It comes in various sizes and folds up for storage when you don’t need it.
  • Particularly in the first week after surgery, you’ll likely spend most of your time propped up in bed or on a sofa. You’ll need extra support for your back to do so. Try the Helix’s Wedge Pillow ↗ (available in two sizes) for support without arms. If you need support that’s not stuffed with feathers and down (like me!), try this backrest pillow made of memory foam ↗. For backrest pillows with arms ↗, there are many options, including ones covered in cotton, velour, microfiber, and other materials.
  • Even if you have your hysterectomy done laparoscopically, post-surgery your lower abdomen will be sore – not just from the surgery, but from bloating (which is common post-anesthesia, as well as during and after taking pain medication). Make sure that you have clothing that fits loosely around your waist for your recovery period. This might be maxi dresses, caftans, shifts, tunics, oversized shirts with oversized shorts, loose soft pants such as harem pants – anything without an elastic or cinched waist! Be sure to pick out clothing that you’ll feel good in (don’t make selections that might seem more physically comfortable but would cause gender dysphoria).
  • Post-surgery, you’ll want to wear flat shoes (no wedges, no heels, no heavy boots) with good support and strong traction (so you don’t slip on smooth floors). As bending over will be painful, particularly for the first few weeks, you might want to consider a shoehorn dressing aid stick ↗.
  • If your hysterectomy is combined with other circumstances such as vaginal birth or pre-existing uro-genital pain (which hysterectomy can aggravate), products such as Private Packs ↗ for warm or cool application over your vulva, perineum, and anus; or Vagikool ↗ for cool-only application, may be helpful. Remember to use a clean cover with each application and to limit use to only 20 minutes at a time.

Sexual Pleasure and Health

For many people, sexual health and pleasure are a necessary part of their lives as healthy people. Unfortunately, having a hysterectomy will place temporary restrictions on your sexual activities. Be sure to check with your doctor’s guidelines as they may differ from person to person.

  • Avoid using external sex toys or hands for clitoral stimulation for the first 2-4 weeks after surgery (check with your surgeon for the time frame that is best for you as blood gathering in your pelvis, such as when aroused, can delay healing). Once you resume, be sure to clean your toys or hands before each use!
  • Avoid receiving oral stimulation for eight weeks after surgery as oral sex can transmit bacteria and cause infection of the surgical site.
  • Avoid receiving vaginal or anal penetration for eight weeks after surgery as both forms of penetration (including with toys and fingers) can cause stitches along the surgery site to rupture. This can lead to permanent damage of the internal organs.
  • Eight weeks after your surgery (if cleared by your surgeon), if you want to introduce or reintroduce penetration, you might want to consider using silicone dilators ↗ to start. Don’t forget to use a water-based personal lubricant with your dilators – I recommend Good Clean Love’s Liquid Water Based Personal Lubricant ↗. You can also use an oil-based lubricant, but avoid using a silicone-based or hybrid lubricant with silicone dilators.
  • You should avoid “warming” and “arousal” lubricants at this time, but CBD lubricants ↗ and THC lubricants can be used as long as they don’t have silicone in them. Please keep in mind that most CBD and THC lubricants are oil-based and therefore should not be used with latex condoms (non-latex condoms are fine). If you choose to use an oil-based lube, you might want to invest in a sex throw or sex towel ↗, as oil-based lubricants are messier than water-based lubes and tend to stain bedding and clothing. If THC-lube is your jam but you can’t find any near you, check out this recipe to make your own personal lubricant with THC ↗.
  • Many people find pelvic floor therapy crucial after hysterectomy due to ongoing pain, scar tissue, hypertonic or hypotonic pelvic floor muscles, and more. Check with your care team to find out if this option might be right for you. Try the Pelvic Rehab ↗ site to find a pelvic floor therapist or other pelvic rehab practitioner near you. If you’re searching for a gender-affirming, trans-competent pelvic floor therapist, you have a few options: you can ask your surgeon for recommendations, try a web search, or if you’re on Facebook, try asking your local Queer Exchange group for referrals.

Links to products, unless the brand names are mentioned within this document, are only examples of the suggested products, and are not endorsements. No product listed here is officially endorsed by the author (Caz Killjoy). There are no affiliate links used. Purchase items from your preferred retailers and use at your own risk. 

The information provided in this document is for educational purposes only, and does not substitute for professional medical advice. Readers should consult a medical professional or healthcare provider if they’re seeking medical advice, diagnoses, or treatment.

Caz Killjoy’s Tips for Total Hysterectomy Recovery © 2023 by Caz Killjoy is licensed under Attribution-NonCommercial-NoDerivatives 4.0 International ↗.

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