Whether you’re considering a hysterectomy or have recently undergone one, you need to be aware that physical and emotional healing takes time.  The amount of time depends on the type of procedure, your age, physical shape, mindset and your personality.  Knowing what to expect after surgery will make your experience easier.

0.1. Hospital Recovery

You will be required to stay in the hospital for 1 to 2 days for post-surgery care.  During this time, a nurse will monitor your vital signs (blood pressure, temperature and heart rate), draw blood, help you eat, dress and take a shower the morning after surgery.  Don’t expect to be running around your hospital room!  Normal everyday activities will take more time after surgery.

It is normal for you to experience pain after your hysterectomy.  Immediately after your surgery, you will receive pain medication.  It is important to take it to prevent pain from worsening.  Controlling pain is an important part of your recovery process.

Two types of pain medications exist.  They are narcotics and non-narcotics.  Most commonly used narcotics are morphine or Demerol. These medications may cause constipation.  Your doctor may recommend that you use a stool softener. You will have excess gas as your bowels recover from the anesthesia.  You will also have an IV which will provide fluids and antibioitics.

For an abdominal hysterectomy, you will probably need a narcotic for a few days.  One effective way to control pain is with a patient controlled analgesia (PCA) pump.  It is simply a pump that allows you to deliver the pain medication yourself through an IV. By pressing a button on this pump, you can give yourself the medication.  Don’t worry, the pump has a safety timer so you won’t overdose yourself.  And, you need not to worry about becoming addicted to these medications.  It is very rare to be become addicted if you are using these medications temporarily to control pain.

If you hear some gurgling or other strange noises coming from your bowels, do not panic. They are normal!  It’s just your bowels recovering from the anesthesia.  You’ll be restricted to a clear liquid diet and limited amounts of exercise that will help get rid of your gas pain.

0.2. Hysterectomy Post-Op Points

• Your nurse will help you get out of bed the first night and help you walk on your own four to six times a day as you begin to feel better.
• A sanitary napkin may be necessary if you experience any vaginal bleeding after surgery.
• Your incision will be checked every day by your nurse and he/she will change the dressing if necessary.
• Non-absorbable staples or stitches will be removed before you go home.
• Your doctor will help you decide when you can resume your usual diet but until then, expect to be on a liquid diet until your intestines begin to function normally.
• Your nurse will monitor your bowel, bladder and lung function daily.

Depending on the condition at the end of your hospital stay, your nurse will discuss the possibility of receiving at-home care.  If you think you qualify for the care from a visiting nurse, discuss your options before you go home.  They’ll also go over your instructions and prescriptions for painkillers and any other medications needed.

Also, don’t forget to ask your doctor any questions you may have before going home and to ask about a follow-up appointment.  Unless you experience an emergency, your doctor will advise you to make a follow-up appointment 2 to 6 weeks after your hysterectomy.  At this visit, your doctor will explain your pathology results, and examine your incision, as well as discuss hormone therapy, and lifestyle changes.

0.3. Returning Home From a Hysterectomy

Recover time does not stop when you leave the hospital.  Complete recovery will take 4 to 8 weeks.  You will gradually be able to return to normal activities.  The first 2 to 3 weeks should be devoted to resting.  The more you rest, the faster you’ll recover.

Arrange for people to help you with household chores before you have your surgery.  And, let them help you!  Don’t do any heavy lifting or strenuous exercise and don’t rush back to work.

Take it easy.  Try to avoid climbing stairs but if you need to, go slowly.  Let someone else drive you around (if you need to leave your house) during the first week or two after surgery.

Here are some tips for a speedy recovery:

• Drink lots of water and other clear liquids.
• Take your pain medication.
• You may need to use sanitary napkins (don’t use tampons).  Expect some bleeding and brownish discharge.  It may last up to five weeks.
• Keep your incision clean.  Wash it daily with soap and water.
• Keep your incision dry and cover it with fresh gauze.  If you shower or bathe, dry it afterwards and do not apply any creams or ointments.
• Don’t use any tampons or douches.
• No sexual intercourse until your doctor advises you (typically 6 weeks).  However, there is no rule for hugging and kissing.
• Contact your doctor or go to the emergency room If you experience any of the following: fever, pain, heavy vaginal bleeding, odorous discharge, swelling in the legs, bleeding or discharge at the site of the incision; frequent or painful urination; persistent vomiting or inability to pass gas; or sudden pain in your chest

0.4. Physical and Emotional Aftermath

It’s not uncommon to feel tired, and a bit irritable after your surgery.  Afterall, you may be experiencing pain, not sleeping as usual, and this may make you feel like a emotional rollercoaster.  If your recovery is lengthy and difficult this may effect your emotional health.

If you find you cannot pull yourself out of your high and low feelings, discuss this with your doctor.   It’s definitely a myth that hysterectomy causes depression and studies have shown that women who do suffer depression after a hysterectomy are those women who had problems before the surgery was performed.

You had (or are having) a hysterectomy to relieve unwanted symptoms of your reproductive system (heavy bleeding, fibroids, uterine prolapse, endometriosis, adenomyosis, chronic pelvic pain and/or cancer of the cervix or uterus).  These physical problems should improve but, other changes may occur.  A hysterectomy can greatly improve your quality of life but also can have long-term effects on your health, longevity and sexuality.

If you have not reached menopause yet and you have a hysterectomy with removal of your ovaries a (bilateral oophorectomy) before the age of natural menopause, expect to undergo surgical menopause. This will cause a sudden drop in estrogen and progesterone and testosterone. A drop in estrogen will cause hot flashes and night sweats and increase your risk of osteoporosis, heart disease, and vaginal dryness.  The decrease in testosterone may reduce your energy levels or sexual desire. The plummeting hormone levels, due to surgical menopause, usually cause more severe menopause symptoms than those going through natural menopause.  The experience is different, however, for everyone.

Women who have had a hysterectomy and bilateral oophorectomy may need to address the issue of hormone therapy earlier in their lives that most women.   Many women are given estrogen therapy ( ET) after a hysterectomy to alleviate their menopausal symptoms like hot flashes, night sweats and vaginal dryness.

Some of the benefits associated with hormone therapy (HT) are:  fewer hot flashes, night sweats; prevention of bone loss; improved health of the vagina and urinary system.  Your doctor may also discuss the use of androgens to improve a low sexual desire. You should not take HT if you have: a personal or family history of breast cancer, cancer of the uterus, a history of blood clots, active liver disease or vaginal bleeding.

It is also important to eat calcium rich foods and exercise.  Staying positive is one of the most important factors to consider when recovering from a hysterectomy.  In some instances, hysterectomy is a life saving operation and can change your life for the better.  It is our hope that you will be happy with the choices that you made whatever course of action you have taken to ensure good health.

To chat with other women, visit our menopause forum.

References

“Hysterectomy Topic Overview.”  WebMD 26 August, 2004.  16 March 2007 http://women.webmd.com/tc/Hysterectomy-Topic-Overview

Minkin, M. J., Wright, C. V., A Woman’s Guide to Menopause and Perimenopause. New Haven: Yale University Press, 2005,  pp.284-320.

“Patient Education:  Preparing For A Hysterectomy.” Yale-New Haven Hospital 5 October, 2004.  16 March 2007. http://www.ynhh.org/pat_edu/hysterectomy/index.html