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Q: Why do I have cramps after a hysterectomy?

by Dr. Barb DePree MD

You describe cramps, not unlike menstrual cramps, after masturbation. Orgasm includes contraction of pelvic floor muscles, and it sounds like you're experiencing some spasms of those muscles. Radical hysterectomies often require tissue removal or dissection surrounding the uterus and ovaries. It's likely your spasms are caused within nerves and muscles that are still healing.

I suspect this will improve with continued healing, but using an anti-inflammatory medication like ibuprofen may help relieve the pain. If, three months or so after surgery, when most healing has taken place, the spasms and pain persist, a consultation with a pelvic floor physical therapist may be helpful. They can assess the muscles and nerves of the pelvic floor and often remedy persistent pain.

Continue that healing work! I'm hopeful the pain will resolve itself.


  • I had a partial hysterectomy about 5 weeks ago caused by endometriosis/ huge fibroids that prolapsed out my vaginal canal. Because the fibroid wasn’t getting blood it went necrotic causing an abscess on my uterine wall. Fast forward to today. The immense pain that I’ve been living with that the hysterectomy was suppose to rectify/alleviate is still here. I’m cramping as if i still have my uterus. I got here because a lot of drs didn’t listen or down played my very severe issues. I can’t get my gynecologist oncologist to hear me. I understand she hasn’t been through what I’ve been through. Because of this pandemic I couldn’t go see a different specialist and we only have one in town any advice. Still experiencing pain on top of their lack of care is literally insult to injury.

    Denise on

  • Natasha, Cramping is usually considered uterine in its source but there are other structures in the area that can cause cramping, mostly bowel or the GI tract. Sometimes adhesions from surgery can cause cramping like pain, especially if ovaries are left behind and are involved in adhesions. The pelvic floor muscles can cause cramping pain and surgery can be a trigger for pelvic floor dysfunction. A careful pelvic exam may be able to determine if the source is pelvic floor or not, and often pelvic floor PT is helpful for this.

    Dr Barb on

  • 2 years ago I had to have a full hysterectomy because I had cancer in my uterus. To this day I continue to have bad cramps, Why?

    Natasha on

  • Antoine, Some hysterectomies are ‘supracervical’ – the cervix is left behind (and maybe a bit of the lower uterine cavity or endometrium), most hysterectomies are removal of the cervix and uterus completely. If it was supracervical you may have a bit of remaining endometrium that responds to the cyclic hormone production from the ovaries and you will shed that endometrium and have a light period, this isn’t too unusual or worrisome. If you are still bleeding after complete removal of uterus and cervix, I can’t explain that bleeding and you need to ask a few more questions about what might be the cause. That would not be expected of explained by still having your ovaries. I hope this makes sense and is helpful.

    Dr Barb on

  • Hi, im 46 years old i had my partial hystectomy last august 2018. Im not married. What i have noticed is that i have menstrual cramping and spotting that lasted 4 or 5 days similar to monthly perior but just spotting i have this sometimes after 2 months sometimes after 3 months this time after one month…its k8nd of weird. I went to see my OB and had check up she said its normal because i still have both ovaries one in the left is started to shrink and the one in the right have a small cyst and no need for me to worry because i am in my pre-menopausal period…but still im not satisfied and im a bet worried. Please help. Thank you

    Antoine on

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