Sex after surgery – what to do when problems arise

It’s not uncommon for surgical procedures to get in the way of your sex life. Surgery affecting parts of the sexual anatomy poses an obvious issue as there’s likely to be pain in the immediate area, but this can also be the case for any type of surgery which leaves the patient with tenderness and pain anywhere on their body – during the sometimes long healing process. Often however, longer term issues arise, both from the pain and visible effects of scarring and loss of self-esteem that can be caused by bodily changes post-surgery. In this article we’ll discuss some common surgical procedures that can cause sexual issues in terms of both pain and self-esteem and what you can expect when it comes to sex after surgery.

Problems following late circumcision

In cultures or parts of the world where circumcision is customary, it is is usually performed shortly after birth, however there are times when it is carried out as an adult. This can be because of a change of religion or medical issues such as a tight foreskin (phimosis) which can create pain when the penis is erect and during intercourse or repeated infections (balanitis).

The procedure can be a relief for men with this condition, however the results can take some getting used to. For a man who has lived most of his life with a foreskin, the removal of it can leave the penis looking very different and also leave the glans (the head of the penis) highly sensitive. Preferred masturbation techniques and sexual habits formed over a lifetime may need to adapt to the more sensitive penis because it may leave a man experiencing over-sensitivity when engaging in sexual massage and intercourse with a sexual partner.

It is possible to desensitise the penis over time, however initially, different techniques may need to be adopted to allow for the change in sensation. Extra lubrication can greatly help, as can the use of condoms to offer an added layer of protection and topical de-sensitising treatments which are available over the counter or on prescription. There is also edging and the withdrawal technique during intercourse, which help to pace the and prolong sex more effectively.

How childbirth and episiotomy can affect sex

For women, one of the most common genital surgical procedures that can affect sex is an episiotomy during childbirth, with the same effects also resulting from natural tearing which is more common today in the UK, as episiotomies are given less routinely. Both will require some stitches to repair the perineum, and pain and recovery affecting sex after surgery can vary depending on how extensive the cut or tear is.

Sex after episiotomy can be very painful at first. Generally speaking, the scarring from either can be tender for a good few months and it’s not uncommon to experience a burning sensation during penetration that can feel very uncomfortable until the skin and muscle has fully healed.

During this healing period is it vital for women (and their partners!) to be patient and take things slowly. Forcing penetration before you are ready can leave you anxious about sex and can affect the healing of the perineum. During this time, alternative techniques to help you reach arousal can be used, such as clitoral massage and stimulation of other erogenous zones. When it comes to satisfying your male partner, some understanding is required on his part but similarly, manual or oral techniques can still allow for some satisfying sexual contact and nurture the bond between you until normal activities can resume.

Caesarean sections require a long recovery too may present many problems as the healing process happens. During the surgery seven layers of tissue are cut, with the scar tissue may become fibrotic, less stretchy and less mobile. Adhesions may form, sticking together layers under the skin. This tight scar tissue and adhesion formation can create “pouch” or “overhang”, create discomfort in back or hips, pulling and numbness sensations, urinary or digestive problems and sensitivity.

Sex after mastectomy

Sometimes sex after surgery is affected by psychological issues. Sexual desire and performance are impacted by psychological issues far more than physical ones. In fact, even the lasting visual scars from surgery do not always have a physical impact on sex, but rather a mental one – affecting self confidence and even creating a sense of embarrassment which creates sexual inhibitions and an inability to ‘let go’ and enjoy sexual encounters.

Mastectomy is one such procedure that is often linked to this issue and given the sexual role of breasts in foreplay and their sexual symbolism in Western cultures, it’s no wonder that the loss of breasts through cancer, can be life changing and a huge blow to sexual confidence. You might be wondering – what can be done to overcome this?

The first step involves coming to terms with your new body. An understanding and supportive partner is absolutely vital when it comes to building your confidence back and looking beyond your breasts to build a sexual connection and other ways to engage in foreplay and build arousal. Counselling as a couple can play an important role in you both getting past this issue. Ultimately the goal is to re-wire the brain into realising that sexual fulfilment and satisfaction doesn’t depend on the breasts and that you can still feel feminine and sexually attractive without them.

The loss of sensation that you might have been used to and dependent on for arousal is a bigger issue to come to terms with and one that may leave you feeling extremely low. However, a deeper understanding of the arousal process and how different parts of the body respond to stimulation can have a huge difference and could even lead to you having better sex than before.

A private massage workshop that teaches just that, can educate both you and your partner and give you a better appreciation for erogenous zones and massage techniques that you might have not even known about.

Disfigurement from plastic surgery

Some surgeries are carried out in order to improve sexual performance or confidence, such as penis enlargement, labiaplasty or vaginal tightening. Ironic that sex could we worse after a procedure like this, but it happens. Whilst these operations are usually successful, they are not without risk and the aftermath of a botched surgical procedure can have catastrophic effects on confidence and sex going forwards and leave the patient feeling worse than before. All is not lost if this has happened to you – sex after surgery of this kind will also be difficult and again it’s a case of reprogramming your brain to accept the new version of you and realising that your sexual sense of self is not dependent on aesthetic values.

The loss of confidence from issues like a small penis for example, can be dealt with through counselling and re-framing your view of male sexuality. Many women will tell you that it’s not how big it is, but what you do with it – your sexual technique counts for a lot. And as this other blog of ours suggests, a big penis has its downsides!

It’s not just men who suffer paranoia about the appearance of their sexual anatomy. The feelings of many women who consider themselves to have ‘untidy’ labia that are protruding or too large or a vagina that isn’t tight enough – are often the result of unrealistic expectations. Take a look at the Great Wall of Vulva, if you don’t believe us! A work of art crafted from the casts of hundreds of women, all totally diverse in their size, shape and appearance and all normal.

Sometimes, as tempting as it can be to address the problem surgically, you may be able to find a solution that doesn’t involve going under the knife.

The effects of scar tissue

Sometimes the scar that’s left behind can continue to cause problems when it comes to sex after surgery – because whilst the human body has an incredible ability to heal, the scar tissue created is strong. Throughout the natural healing process, scars undergo four distinct stages, often leading to discomfort, pain, pigmentation issues, limited mobility, disfunction and adhesions, not mention lack of or over sensitivity. ScarWork is a groundbreaking and transformative approach to postsurgical care and scar management through massage.

Both caesarean sections and mastectomies can result in tough and painful scar tissue. In the case of caesarean sections seven layers of tissue are cut leaving tissue fibrotic, less stretchy and less mobile. Adhesions may form, sticking together layers under the skin. This tight scar tissue and adhesion formation can create a ‘pouch’ or overhang, creating discomfort in the back and hips, as well as pulling and numbness sensations, urinary or digestive problems and sensitivity.

During mastectomy surgery, the surgeon may remove the breast tissue, muscles and lymph nodes, which can change the way your body moves and functions after the surgery. Adhesions may form in the chest and rib cage area that can lead to fascial restrictions creating limitation, pain and reduced function of the neck, shoulder, back, as well changes to breathing and postural alignment.

We spoke to Violet Meyer, a chronic pain specialist and scar massage specialist at Battersea Massage to find out more: “With ScarWork Therapy, you’ll encounter a gentle and non-invasive treatment that yields remarkable changes to your scars, instilling newfound self-confidence. Beyond aesthetics, ScarWork also addresses adhesions and restrictions that may cause sensitivity and discomfort in intimate areas of your body.”

Scar Therapy, including ScarWork and scar massage, holds the key to unlocking a brighter future for patients with scarring at various stages of maturity, as they not only release fascial restrictions and fibrotic tissue but also nurture your emotional well-being, enhance scar healing and improve the way scars look and feel.

Time is a healer

In conclusion, surgery, whether elective or necessary on grounds of health, can have a profound effect on sexual confidence and sense of self, sometimes for the better – often for the worse. If you find yourself in the latter position where sex after surgery is problematic, then there are things than you can do to address the issue and the good news is that with the right support and measures in place, it shouldn’t have long term effects on your sexual fulfilment or happiness.

The important thing is to have patience. If you’re post-surgery and still in pain, your body needs time to heal. Getting used to a different appearance takes some time also, so you shouldn’t rush the process of coming to terms with this.

At Intimacy Matters, sex engineer Colin Richards specialises in helping people to rediscover their sexual fulfilment and to work through any problems that may be getting in the way of this. You can contact Colin at any time to discuss your problem and he will suggest the best way forward for you.