Pelvic Floor Dysfunction Can Occur After a Hysterectomy
If you’ve had a hysterectomy or know anyone who has had one, you already know there is so much more to recovery than just healing a couple scars.
You may be worried about getting your energy back, navigating returning to exercising and your hobbies, managing pain, getting your bladder and bowel habits back to normal, and wondering when you’ll finally feel like yourself again!
But there is one part of recovery that often gets overlooked (and it’s an important one!): your pelvic floor.
We treat a lot of women in the Pewaukee area following pelvic surgeries, and hysterectomy is one we see all the time. While a hysterectomy can be a life-changing and necessary surgery for a lot of women, it’s still a major surgery that affects your entire body – including your pelvic floor!
Causes of Pelvic Floor Dysfunction After a Hysterectomy
There are many reasons why pelvic floor dysfunction can occur following a hysterectomy:
- Your nervous system goes into protection mode. Surgery is a big deal! Your nervous system perceives a threat to the body (the surgery itself) and creates muscle tension in the pelvic floor in response.
- Your other pelvic organs may adjust position a little bit after the uterus is gone. Our pelvic floor muscles support our internal organs, so these muscles must adjust to any position changes too.
- You now have scar tissue that impacts pelvic floor function. Scar tissue is a normal part of healing. However, it can sometimes become restricted and affect how the surrounding tissues move and function.
- Pain can cause muscle tension. Your post-surgical pain may cause your nearby pelvic floor muscles to become tense.
- Hormonal changes can affect the pelvic floor. If they remove your ovaries, you now go through surgical menopause. The drastic drop in hormones (especially estrogen) directly impacts the tissues of your vaginal canal and pelvic floor.
What Does Pelvic Floor Dysfunction Feel Like After a Hysterectomy
You’re probably expecting some pain and discomfort after surgery. That’s normal.
But what if you’re still having symptoms weeks or months later?
I’ve seen a lot of women with pelvic floor tension (not usually weakness) following a hysterectomy. And this can still be present months after the surgery. Is this surprising to you?
If you have pelvic floor dysfunction after a hysterectomy, you may experience:
- Pelvic, back, or tailbone pain
- Constipation
- Leaking
- Urinary urgency or frequency
- Pelvic pressure or heaviness
- Discomfort with intercourse
And here’s the important part: you don’t have to just accept these symptoms as your “new normal.”
Hysterectomy Recovery Tips
Early Recovery: Start Slow
First things first: give yourself permission to recover.
I know that is easier said than done.
You have a house to take care of, kids asking for snacks every 12 seconds, laundry that somehow multiplies overnight, and a million other things you’d like to be doing.
But your body just had major surgery. It needs time.
Follow your surgeon’s specific restrictions and recommendations, and when your body is ready, start with gentle movement.
Simple breathing and mobility exercises can be a great place to start.
Here are 2 of my favorite mobility exercises:
Short, easy walks are another great way to start moving again. A 5 minute walk around the house or down the street is a great place to begin.
Listen To Your Body
One of the most important tips I give to women who have pelvic floor dysfunction following a hysterectomy is listen to your body.
Your body is constantly giving you feedback about how it’s handling what you’re asking it to do.
Some signs that you may be doing too much include:
- Increase in post-surgical pain
- Onset of new pain anywhere
- Leaking
- Pelvic heaviness or pressure
Think of these symptoms as your body’s way of saying, “Hey, let’s maybe not do quite as much today.”
Slowly Progress Back to the Things You Love
The key to progressing back into exercise, hobbies, and the activities you enjoy doing is to slowly increase what you are doing over time.
Once your body is ready, begin incorporating some simple body weight strengthening exercises like:
And here is where that breathing (see video below) you practiced early on becomes really important. Try incorporating your breath into your strengthening exercises to help restore coordination between your diaphragm, abs, and pelvic floor muscles.
Inhale into your belly and ribs during the easier part of the exercise.
Exhale during the more difficult part of the exercise.
As your strength and symptoms improve, you can gradually add resistance, weights, impact, and more challenging activities.
Pelvic Floor Physical Therapy – A Must!
One of my favorite things to hear from a post-hysterectomy client is, “I can’t believe my doctor didn’t recommend pelvic floor physical therapy after my hysterectomy. I’m so glad I reached out!”
I’ve heard this from multiple women.
After a hysterectomy, you may have been given instructions about incision care, temporarily lifting and activity restrictions, medications, and a follow-up appointment. BUT nobody may have talked to you about how your pelvic floor is doing.
Your recovery shouldn’t just be about making sure the surgical incision heals well. It’s about helping your whole body return to functioning well.
In pelvic floor physical therapy post-hysterectomy we work on:
- Manual work to reduce pelvic floor tension, as well as any other tension present in your hips, back, and abdominal muscles
- Scar tissue mobilization
- Breathing and relaxation strategies
- Mobility exercises
- Strengthening exercises
- Improving bowel and bladder function
- Guide you with safely returning to exercise and any other activities or hobbies you enjoy doing
Most importantly, your treatment needs to be individualized to YOU and where you are at in your recovery. No two women recover from a hysterectomy identically.
Pelvic Floor Dysfunction After Hysterectomy Isn’t Something You Have to Deal With!
If you’ve had a hysterectomy and you’re still dealing with pain, pelvic pressure or heaviness, leaking, constipation, urgency, or discomfort with intercourse, you don’t have to live with it!
If you’re recovering from a hysterectomy and something just doesn’t feel quite right, reach out if you’re in the Pewaukee area! You deserve more than simply being told, “That’s normal after surgery.”
And it’s never too late to get help! Whether your hysterectomy was 2 months ago or 10 years ago, pelvic floor physical therapy can help you address lingering symptoms and get you back to feeling like yourself!
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