After childbirth or a major surgery like a hysterectomy, your doctor probably told you when it was safe to resume sexual activity. But what they may not have explained is that “safe” doesn’t always mean “pleasurable” or “the same as before.” If you’re now experiencing pain, a lack of sensation, or difficulty with arousal, you are not alone. It’s a silent struggle for many women, who may find themselves searching for extreme scenarios, asking things like, “can you break your pelvis from sex?” out of sheer frustration. The reality is that pelvic trauma, whether big or small, can disrupt the intricate systems that govern sexual response. This isn’t just in your head; it’s a physiological issue that deserves real answers and effective solutions.

Pelvic trauma, whether through surgery or injury, can do major damage to any happy healthy sex life.  How?  Any kind of major pelvic surgery or injury can damage the nerves and blood vessels leading to the vagina and clitoris. If this happens, the blood flow through the arteries may be diminished or cut off entirely, leading to a loss of sexual sensation and a reduced ability to become sexually aroused. Some common causes of pelvic trauma include Hysterectomy, Uterine Embolization, childbirth, or straddle injuries. Hysterectomy: This is the removal of the uterus along with the cervix. This is the second most common pelvic operation for women after Caesarean sections. While most gynecologists and sexologists say that a hysterectomy should not negatively affect a woman’s sexual response, the research shows conflicting and contrary data. While some studies report positive sexual outcomes after hysterectomy and others show negative outcomes, no study has shown 100 percent results either way. We believe that injury to the uterovaginal and cervical plexus during hysterectomy may affect blood flow and lubrication thus affecting sexual and orgasmic response. Removal of the uterus can diminish or eliminate pelvic floor orgasms and scarring in the vaginal cuff can make intercourse painful. Uterine Embolization: This is a relatively new technique used in the treatment of uterine fibroids (benign tumors that can cause pain and bleeding). In this procedure, the physician inserts small plastic particles into the uterine artery to cut blood flow to the tumors. Some women who had prior pelvic floor orgasms report a loss of uterine contractions and sensation after this procedure. Childbirth trauma: This can occur as a result of vaginal tearing due to use of suction or forceps, which can cause nerve and vascular damage to the vagina and clitoris. An episiotomy can cause sexual problems if the incision is large or not properly closed. Straddle injuries: These injuries can result from falling on a bicycle or balance beam, as well as pelvic fractures which can cause trauma not only to the pubic bone, but to other structures in the pelvic area including the vagina, clitoris, urethra, uterus, and bladder and their corresponding arteries and nerves. What Can You Do?  It is important to seek evaluation and treatment from a doctor who is trained in diagnosing sexual dysfunction secondary to pelvic injury. You should be evaluated for blood flow, genital sensation, as well as receive a neurological work-up to determine the degree (if any) of nerve damage. Depending on the kind and extent of damage done, there are some treatments available including blood flow enhancing agents and devices, as well as creams that can help restore some degree of sensation and arousal.

Frequently Asked Questions

My doctor cleared me for sex after my hysterectomy, but it’s painful and I can’t get aroused. Is this normal? It’s a common experience, but you shouldn’t have to accept it as your new normal. While a hysterectomy can be a necessary procedure, it can sometimes injure the complex network of nerves and blood vessels responsible for arousal and orgasm. Scar tissue can also cause pain. Your experience is a valid physiological issue, not a psychological one, and it deserves a real medical investigation.

Can childbirth trauma from years ago still affect my sexual sensation now? Yes, absolutely. The effects of childbirth trauma, like significant tearing, an episiotomy, or damage from forceps, aren’t always immediately obvious. Over time, scar tissue can tighten or nerve damage can become more apparent, leading to a gradual or sudden decrease in sensation or an increase in pain. It’s never too late to address these issues.

Are the changes to my sex life permanent after a pelvic injury or surgery? Not necessarily. While some changes can occur, many issues with sensation, arousal, and pain can be managed or improved with the right approach. The key is getting a proper diagnosis from a specialist who understands the connection between pelvic structures and sexual function. Once the specific cause is identified, a targeted treatment plan can help restore function and pleasure.

What kind of specialist should I see for these issues? My regular gynecologist says everything looks fine. You should seek out a doctor who specializes in female sexual medicine or a urologist with a focus on sexual dysfunction. These experts have advanced training to look beyond standard gynecological health. They can perform specific tests to evaluate blood flow, nerve sensitivity, and other factors that your regular doctor might not be equipped to assess.

What does an evaluation for post-trauma sexual dysfunction actually involve? A specialized evaluation is a comprehensive look at what’s happening with your body. It typically includes a detailed discussion of your history and symptoms, followed by a physical exam. The doctor may also use special tools to measure blood flow to the clitoris and vagina and test the sensitivity of your genital nerves. This helps pinpoint the exact source of the problem so a personalized and effective treatment plan can be created for you.

Key Takeaways

  • Painful Sex After Trauma is a Physical Issue: Changes in sensation or pleasure after events like childbirth or a hysterectomy are often due to real physiological damage to nerves and blood vessels, not just psychological blocks.
  • Common Procedures Can Impact Sexual Function: Be aware that major pelvic events, including hysterectomies, childbirth, and even treatments for fibroids, can unintentionally alter the structures responsible for arousal and orgasm.
  • Seek an Expert Diagnosis for Real Solutions: Instead of living with the changes, consult a specialist in female sexual health. A thorough evaluation of blood flow and nerve function can pinpoint the problem and lead to effective treatments that restore sensation.

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