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Dr. C.
Dr. C., Board Certified
Category: OB GYN
Satisfied Customers: 2537
Experience:  30 years of experience and an award-winning educator.
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I'm around 9 weeks post op from a single incision total

Customer Question

I'm around 9 weeks post op from a single incision total hysterectomy with both ovaries removed. We attempted to have intercourse but I started bleeding a lot and then sudden stabbing pain afterwards. Was it just too soon or should I call my OBGYN?
Submitted: 2 years ago.
Category: OB GYN
Expert:  Dr. C. replied 2 years ago.

Usually by 9 weeks everything would be healed enough for sex. We usually have women refrain from sex for 6 weeks. But if you had a lot of bleeding and pain, then yes a call to the gynecologist would be a good idea. It would be very unusual but it's possible that something tore. Hopefully just a minor tear in the vaginal wall from not having had sex for a while.

Customer: replied 2 years ago.
Okay, thank you. I haven't started my HRT yet so I know that causes vaginal dryness but it was a good amount of bright red blood, along with the dryness, and pain.
Expert:  Dr. C. replied 2 years ago.

In that case it could very well have been a vaginal tear. There can be quite a bit of bright red bleeding from such a tear. They are usually visible on exam and the treatment is just to give the area time to heal. If severe and the bleeding is continuing and heavy, it can require a stitch but this is VERY rare. It would be best to start the HRT possible adding some vaginal estrogen too. That would strengthen up the tissue quality and help with the dryness and pain. Let me get you some more detailed information about that. I'll be right back.

Expert:  Dr. C. replied 2 years ago.

Most likely, some vaginal estrogen cream or tablets will be helpful. The symptoms are very common in women who are in menopause or nearing menopause. It is usually quite easy to solve. Estrogen cream is cheaper but messier to use. Vagifem tablets are easier to use but more expensive. Women need to check with their insurance to see if they have coverage for both equally. If so, the Vagifem tablets are preferred. Although it's an estrogen product, there is virtually no absorption into the blood stream of estrogen. So even though the package insert (which is required for all estrogen products by the FDA) will say things about breast cancer, blood clots, etc., these warning do not apply to the Vagifem product. There is somewhat more absorption into the blood system with the cream. The only reason why women will definitely want the tablets is if a woman has a history of breast cancer, blood clots or heart attack. The proper usage is to use for the 2 products is as follows:

Estrace (estradiol) cream - use 1 gram nightly for 7 nights, than use 1 gram twice weekly

Vagifem pellets - use one pellet nightly for 14 nights, than use twice weekly

Most women will notice an improvement within 2 weeks.

Expert:  Dr. C. replied 2 years ago.

Many women need extra estrogen vaginally in addition to whatever they're taking systemically for management of hot flashes or night sweats.

Anything else I can help with tonight?

Customer: replied 2 years ago.
No thanks, ***** ***** very helpful.
Thank you for your time.
Expert:  Dr. C. replied 2 years ago.

You're welcome. I hope it stops and heals quickly. Please leave a rating for my service. I aim for excellent and appreciate your feedback. Thanks.