The Surgical Recovery Playbook

Whether you're having a laparoscopy for endometriosis, ovarian cyst surgery, a hysterectomy, hysteroscopy, myomectomy or a LLETZ procedure, it's completely normal to feel nervous about surgery.

One of the most common questions I hear from patients is: "What should I expect afterwards?"

While every woman's recovery is different, a little preparation can make a big difference to how you feel, how well you heal, and how quickly you return to the things you enjoy.

This guide brings together practical advice to help you prepare for surgery and navigate your recovery with confidence.

Before Surgery: Setting Yourself Up for Success

Preparing for surgery starts well before the day of your procedure.

Understand Your Procedure

During your consultation we will discuss:

• why surgery has been recommended

• what the procedure involves

• expected benefits and outcomes

• risks, alternatives and recovery expectations

I encourage patients to ask questions. Feeling informed is one of the best ways to reduce anxiety and feel confident moving forward.

Organise Your Recovery Space

A few simple preparations can make the first few days much easier:

• arrange a support person to drive you home

• prepare some easy meals in advance

• have paracetamol and ibuprofen available

• organise loose, comfortable clothing

• keep a heat pack nearby

• consider stool softeners if you are prone to constipation

If you have young children, pets, or caring responsibilities, it can be helpful to arrange extra support for the first few days.

What to Expect After Surgery

Recovery depends on the type of procedure performed.

Minor procedures such as hysteroscopy, cervical biopsy or LLETZ usually involve a relatively quick recovery, while laparoscopic surgery, robotic surgery or hysterectomy require more time for internal healing.

Even when the incisions are small, your body still needs time to recover.

The First Few Days (Days 1–3)

This period is often the most challenging.

You may experience:

• tiredness

• bloating

• shoulder-tip pain after laparoscopy

• mild pelvic discomfort

• light vaginal bleeding or spotting

• reduced appetite

Helpful tips:

• take pain relief regularly

• drink plenty of fluids

• start with light meals

• walk short distances throughout the day

• use a heat pack for comfort

• prioritise rest and sleep

Many women are surprised by how tired they feel. Fatigue is one of the most common and normal parts of recovery.

Week One

The focus during the first week is healing and gentle movement.

Most women find they:

• tire easily

• need regular naps

• have mild wound tenderness

• experience occasional spotting

Gentle walking is encouraged, but avoid:

• heavy lifting

• strenuous exercise

• abdominal workouts

• housework that requires significant bending or lifting

Weeks Two to Four

During this stage most women begin to regain their normal routine.

You may notice:

• improving energy levels

• less discomfort

• increased confidence with movement

• occasional "twinges" or pulling sensations as tissues heal

Many women can return to desk-based work during this period, although recovery varies depending on the complexity of surgery.

Gentle activities such as walking, stretching and yoga can often be resumed.

Weeks Five to Six

By six weeks many women feel significantly improved.

You may be ready to:

• return to normal daily activities

• gradually increase exercise

• resume sexual activity if advised

• return to work without restrictions

However, internal healing continues beyond six weeks, particularly after complex endometriosis surgery or hysterectomy.

Managing Common Recovery Challenges

Pain

Most women experience manageable pain following surgery.

Helpful strategies include:

• regular pain relief

• heat packs

• gentle movement

• adequate sleep

• hydration

Constipation

Constipation is extremely common after surgery and anaesthetic.

To help:

• drink plenty of water

• eat fibre-rich foods

• consider stool softeners if recommended

• walk daily

Emotional Recovery

Recovery is not only physical.

Many women experience emotional ups and downs following surgery. Hormonal changes, fatigue, disrupted routines and the stress of surgery can all contribute.

Be patient with yourself and remember that recovery is rarely a perfectly straight line.

Sex After Gynaecological Surgery

One of the most common questions women ask after surgery is, "When can I have sex again?"

The answer depends on the type of procedure you have had and how your recovery is progressing. For most laparoscopic procedures, hysteroscopy, ovarian cyst surgery, endometriosis surgery, myomectomy and hysterectomy, sexual activity can usually be resumed once healing is complete and your surgeon has confirmed it is safe to do so.

This is often around 4–6 weeks after surgery, although recovery timelines vary between individuals and procedures.

What Might I Notice?

It is normal for intimacy to feel a little different when you first resume sexual activity.

Some women experience:

• mild tenderness or sensitivity

• a feeling of tightness, particularly if the pelvic floor muscles are tense

• mild pulling sensations as tissues continue to heal

• a need for additional lubrication

• anxiety or reduced confidence about returning to sex

Having sex should not damage or "undo" your surgery once healing is complete.

Tips for a Comfortable Return to Intimacy

• Take things slowly and progress at your own pace.

• Use a water-based lubricant if needed.

• Choose positions that feel comfortable and allow you to control depth and movement.

• Focus on comfort and connection rather than performance.

• Start with non-penetrative intimacy if that feels more comfortable.

• Stop if something feels painful and try again another time.

The Role of the Pelvic Floor

Following surgery, some women develop increased tension in their pelvic floor muscles, particularly if pain has been present for a long time before surgery.

Pelvic floor physiotherapy can be incredibly helpful for women experiencing:

• pain during sex

• pelvic floor muscle tension

• fear or anxiety around intimacy

• persistent pelvic pain despite otherwise successful surgery

Emotional Recovery Matters Too

Recovery is not only physical.

It is common to feel nervous, cautious or less interested in sex during the recovery period. Give yourself permission to return to intimacy when you feel ready, rather than feeling pressured by a particular timeline.

Open communication with your partner can make this transition much easier.

When Should I Seek Help?

Please contact your healthcare team or seek urgent medical review if you experience:

• fever or chills

• increasing abdominal pain

• heavy vaginal bleeding

• persistent vomiting

• wound redness or discharge

• difficulty passing urine

• shortness of breath

• chest pain

Follow-Up

Most women will have a follow-up appointment within 2-6 weeks of surgery.

This provides an opportunity to:

• review healing

• discuss pathology results

• assess symptom improvement

• plan any ongoing treatment or fertility care

Final Thoughts

Recovering from gynaecological surgery takes time, patience and kindness toward yourself.

Some days will feel easier than others, and that's completely normal.

By preparing ahead, pacing your recovery and listening to your body, you give yourself the best chance of a smooth and confident return to health.