Why You Still Don't Feel Like Yourself After Your Hysterectomy (And Why That's Not a You Problem)
Let me tell you about a type of woman I see in my practice all the time.
She had a laparoscopic hysterectomy. Same-day procedure. No visible scars. She went home that afternoon. Her surgeon told her she'd be back on her feet in six weeks, and she believed them because why wouldn't she? It sounded straightforward and manageable.
And then months passed. And she still didn't feel right.
Her core is weak in a way she can't quite explain. Sex is painful. She has this vague, persistent feeling that something in her body isn't working the way it should. And because there are no scars to point to, no dramatic recovery story to tell, she's spent a long time wondering if it's in her head.
It's not.
The problem with "minor" surgery
Hysterectomy is one of the most common surgeries performed on women in the United States. What it is not: minor surgery. Laparoscopic, Robotic, Abdominal, Vaginal…all versions are a major disruption to your body.
The uterus does not exist in isolation. It is surrounded by a complex web of connective tissue, nerves, blood and lymph vessels, and muscle. It sits in relationship with your bladder, your bowel, your pelvic floor, your diaphragm. When it is removed, all of those structures are affected. The body has to figure out a new normal, and that process takes time and support and, frankly, information that most women are never given.
That last part is what I want to talk about.
What nobody told you (and why it matters)
I have worked with women who are decades out from their hysterectomy. Decades. And they are only now connecting the dots between that surgery and the pelvic floor dysfunction they've been quietly managing ever since. The weak core. The leaking. The painful intercourse. The chronic low back pain. The scar tissue that never got treated because nobody told them it needed to be.
They are not outliers. They are the norm.
Here's what tends to happen: a woman has her surgery, recovers from the immediate procedure, and gets the all-clear at her follow-up. She goes home and tries to get back to her life. If things feel off, she's often told it takes time. If she asks specific questions, she may get general answers. And if she keeps feeling off past the point where she "should" be better, she starts to wonder if she's the problem.
She is not the problem.
The gap here is not about bad surgeons. Most surgeons are focused on what they trained to do, which is perform the surgery well. Postoperative pelvic rehabilitation, hormonal shifts, nervous system recovery, scar tissue mobility, core reconnection, sexual health after surgery: those conversations often fall through the cracks. Not out of malice. Just out of a system that was never designed to follow women all the way through.
And that's not me being cynical. That's just what I've seen over and over again.
When recovery feels bigger than you expected.
Same-day surgery can still require months of real recovery. A laparoscopic incision does not mean your internal structures healed overnight. No visible scarring on the outside does not mean no scar tissue on the inside.
Your body went through something significant. The fact that it happened in an outpatient setting does not change that. The fact that your neighbor had the same surgery and bounced back in three weeks does not change that. Bodies are unique, hormones are nuanced, recovery is nuanced. There are a million factors that influence how you and your body feel.
If you have been struggling and wondering why, that question deserves a real answer. Not a platitude. Not a "just give it time." An actual answer rooted in what is happening in your body.
What recovery actually involves
Beyond the surgical site itself, a hysterectomy affects your hormonal environment, your sleep, your metabolism, your nervous system, and your pelvic floor. These things are all connected, and they don't all heal on the same timeline.
Scar tissue, for example, can affect the mobility and function of surrounding structures for years if it's never addressed. The pelvic floor, which was supporting structures that no longer exist, has to adapt. The core, which relies heavily on coordination between the diaphragm, the pelvic floor, and the deep abdominals, often needs specific rehabilitation to reconnect effectively.
You are not broken. You are under-supported. Those are very different things.
The good news is that it is not too late. Whether you are three months out from surgery or fifteen years out, your body is adaptable. The work you do now matters.
A place to start
I put together a free guide on the five mistakes women most commonly make in hysterectomy recovery. Because knowing what's actually going on in your body is how you recover not just faster, but better.
[Download the free guide here.]
If you picked up this post and recognized yourself in it, I want you to know that recognition is important. Over and over, women come to me lost, confused, and unheard. They thought it was going to be simple. And when that's not the story, they're angry, frustrated, and worried.
If you're angry or frustrated or just exhausted from not having answers, I get it. That's the appropriate response to being let down by a system that should have done better.
And you don't have to keep figuring this out alone.