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MiddlesexMD

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.


41 comments


  • Rhonda-Usually with pelvic cramping we think of the uterus as the most likely source but now without that other options might be bowel, or pelvic floor muscles. Pelvic floor muscles are a bit more likely because of more recent surgery. Ovaries, with ovulation may be described as cramping pain, but that would likely be cyclic.

    Dr Barb on

  • Hello Dr. Barb. I’m 45 and I had a hysterectomy back in Sept 2019. I still have both my ovaries but what I’ve noticed is that I have cramps all the time not just a week leading up to what would have been my cycle.
    What would that be?

    Rhonda on

  • Shawna: Without a uterus the other most likely organ in that vicinity that cramps is the GI tract, and this also could be a result of post surgical adhesions. You don’t mention whether or not you retained your ovaries, if you still have ovaries they too could cause some cramping. Generally we don’t think of cramping as a particularly worrisome symptom.

    Dr Barb on

  • I had a hysterectomy at 26 and I am now 36 I do biote pellets every 3 months but I have started cramping almost like I am going to have a period. I had to have everything removed so there is nothin left for me to even have cramping. What could be causing this, I have been doing biote for a year and have a wonderful Dr that has been my dr for 20 years but I am really nervous about why this cramping has started.

    Shawna on

  • Michelle, I suspect the residual pain and cramping may be related to post-infectious adhesions involving bowel. There aren’t many other organs remaining that would cause cramping. Please follow up with your surgeon.

    Dr Barb on

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