Mindfully return to usual activities

Ask your surgeon when you can resume your usual activities.

The information below are some common post-operative recommendations and does not replace the information you receive from your surgeon. If there are any difference, you should follow your surgeon’s instructions.

Common recommendations are listed below:

Rest

Rest is important for your recovery. Your body does its healing while you rest. Take naps or rest breaks during the day.

Driving

Avoid driving for 2-4 weeks and until you are no longer taking any opiate pain medication or feeling distracted by pain. Start with short trips so as not to put too much pressure on your genitals. If you drive long distances, take frequent stops & pee often.

Lifting

Avoid lifting objects over ten pounds until 4-6 weeks after surgery.

Work

Take at least 8-12 weeks off work, or longer, depending on the type of work and how you are healing. Check with your surgeon, GP, or NP before going back to work.

Exercise

Ask your surgeon about when it is safe for you to resume exercising. It is usually recommended to wait for 8-12 weeks after surgery before participating in physical activity.

Your surgical team may recommend you have a session with a pelvic floor physiotherapist prior to/or after surgery. This will help teach you how to relax the muscles in your pelvic area, which can help with dilations and future sexual activity. You may be surprised how tired you feel when you start exercising again- this is a normal feeling. Your energy levels will improve as you continue to heal.

  • Continue with your deep breathing and coughing exercises
  • Begin by taking short walks, and gradually increase how far you walk
  • You may notice a connection between exercise and the feelings of increased tenderness or swelling the next day
  • Adjust your activity levels according to the feedback from your body

Sexual Activity

Lots of people have questions about returning to sexual activity after surgery. This can include, but is not limited to, masturbation and sex with other people. As with all other activities, speak with your surgeon about when it is safe for you to be sexually active after surgery.

Exploring how your body feels and responds after surgery is an important step in your healing process. It stimulates the nerve endings, helping them heal and reconnect, and allows you to begin the process of finding where and how you enjoy being touched. It also helps your brain to create a new “map” of your body.

First 10 days after surgery

Avoid activities that can lead to elevated blood pressure and the risk of internal bleeding (hematoma).

This includes:

  • Having any kind of sex (alone or with a partner)
  • Having an orgasm
  • Activities that create risks for bleeding, increase the risk of discomfort or pain or that may disrupt your anatomy while it heals

8 weeks after surgery

  • You can usually begin to gently explore the clitoral area
  • Using vibrators on different settings (low, medium, or high) or with different motors (rumbly or buzzy) may be helpful
  • Many of your sensitive nerve endings are located just above and at your clitoris, so touching, massaging, or using a vibrator in this area can be useful
  • Do not place anything inside your vagina or rectum beyond what has been recommended by your surgeon(s)
  • See the Workbook for Vaginoplasty and Vulvoplasty Surgery in BC for some suggested mindfulness activities.

12 weeks after surgery

Wait until 12 weeks after surgery before having oral, vaginal, and anal sex. Some people may need to wait longer depending on their healing and pain levels.

Here is some general information for returning to sexual activity after surgery:

  • Follow your surgeons’ recommendations regarding return to sexual and other physical activities.
  • Take time to learn your body’s needs and preferences.
  • Ease back into your sexual activities.
  • You may find your sex drive is different from before surgery. It might be lower during your healing period or you might find it’s higher. Everyone is different. It’s important to know that changes to your sex drive are a normal part of your healing journey and will balance out over time.
  • Do not place anything inside your vagina or rectum other than what has been recommended by your surgeon(s).
  • Most people need to use lubricant during vaginal sex- this helps to increase sensations of pleasure and also prevent uncomfortable friction or skin tearing.
    • Some people like to use a different kind of lubricant than the one they use during dilation, though this is optional.
    • If you and your partner(s) use condoms, choose water- or silicon-based lubricant.
  • You may find that your endurance or tolerance for different activities and sensations is affected by your surgery or pain medications.
  • You may feel gentle stretching of your vagina or vaginal opening during sex- this can be normal.
  • Stop or take a break if you feel pain, or you feel anxious or scared.
  • Pay attention to whether your swelling or tenderness increases after sex- if so, you may want to wait until you are a bit further along in your healing before having sex again.
  • Pee before and after sexual activity to reduce the chances of urinary tract infections (your urethra is shorter now and bacteria can easily get pushed inside during sexual contact).
  • Avoid activities that can lead to internal or external bleeding, compromised blood flow, and injury to nerves and healing tissues. This includes:
    • tiring and repetitive movements
    • activities that could affect (stretch/tear) incisions (inner or outer) until your surgeon confirms that your incisions have healed
    • sudden or vigorous movements
    • lifting more than 10-15 lbs
    • strenuous activity (including sex)
    • bondage, suspension, pinching, squeezing, vigorous massage
    • flogging, spanking, paddling buttocks, thighs and other non-genital areas
    • very hot and very cold temperatures until nerves have fully healed
  • It can be helpful to speak with your surgeons before starting any BDSM activities in the months after surgery. Your surgeon will likely welcome these questions. If you are shy, you can be creative and ask about returning to full contact sports, swinging a tennis racket, receiving vigorous massage, riding a horse, using a heating pad or wearing restrictive or body-shaping clothing. 

A note on safer sex and STI screening

Many people find that they are better able to relax and enjoy partner sex if they have spoken with their partner(s) about sexual health and STI screening.

It is possible to get sexually transmitted infections (STIs) after vaginoplasty. The following recommendations can help reduce the chance of getting an STI. These recommendations are general and apply to anyone, whether they have had vaginoplasty surgery or not. Not every recommendation will apply to you, but they are helpful to be aware of:

  • Ask your partner(s) to wear condoms during sex (including vaginal and anal sex)
  • Ask your partners to have STI screening, including chlamydia, gonorrhea, HIV and syphilis.
  • Avoid having vaginal sex (or use condoms) if you have vaginal irritation or inflammation (for example, hypergranulation tissue)
  • Speak with your GP or NP about how often you would benefit from getting STI screening (this is based on your sexual activities)
  • Learn about HIV Pre-Exposure Prophylaxis (HIV PrEP) and speak with your GP or NP if you think this might be a good option for you