Back to Love by Pritchett & Hull Associates, Inc.

sex after hip replacement

Product # 228A

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Like other parts of your life after surgery, getting back to sex can be exciting, as well as a bit scary. Now that youâ&#x20AC;&#x2122;ve had your hip replaced, you may be thinking about intimacy and sex. This book can help you and your partner: regain an active, healthy sex life talk about sex, your feelings and concerns learn other ways to find pleasure learn some possible positions to help protect your new hip during sex know about dislocating your hip and what to do if that happens Talk with your partner and doctor about your feelings and your new hip before you resume sex. Read this book with your partner so you can discuss questions or concerns you both have. On the inside back cover, write down questions you have for your doctor.

This book is only to help you learn, and should not be used to replace any of your doctorâ&#x20AC;&#x2122;s advice or treatment.

That loving feeling Once you feel interested in having sex, you want to know when you can get started. Many people return to sex within several weeks of surgery. For others, this is not nearly long enough. Everyone’s time frame is different. It depends on: any surgical precautions your plan of care your type of surgical dressing and incision your age your overall health (physical and mental) how well you are healing from the surgery You’ll know when you feel ready to take the next step. If you are still in pain or are not comfortable with the thought of having sex, don’t. If you think you are ready, talk to your

doctor to make sure it’s safe for you to start having sex again.

Slow motion is the love potion Once you’ve healed and the doctor says it’s OK to have sex again, take it easy and go slowly. Listen to your body. If you feel pain or discomfort, stop—especially at first! You need to be careful to protect your new hip. Plan time for sex. Pick a time when you feel good, and make it special and romantic. This can help you relax. The more relaxed you and your partner are, the more comfortable you will be.

The emotional side Even if you are free from joint stiffness and your body is ready for sex, emotions (yours and your partner’s) may get in the way. Sharing your feelings at this time is important, because one or both of you may have fears. For instance, your partner may worry about hurting you during sex, but you may think he or she is not interested. In fact, your partner may be trying to protect you. The best thing you can do is talk things out. Tell each other how you feel, what hurts or is uncomfortable, what concerns you and what you need from each other. Don’t put too much pressure on yourself. Wait until you’re ready, and when you are, let your partner know.

Many times surgery and the medicine to put you to sleep can make you feel "blue". These feelings should pass in time.

When to get help If you have questions about sex or need help, ask your doctor or nurse. They can answer your questions, provide additional facts or refer you to someone else if needed. If you don’t bring up the subject, they may assume that you already have the information and support you need. If it’s hard to talk with your partner, it may help both of you to talk with a social worker or psychologist. They have special training in sexual issues. And some only work with people who have sexual concerns due to injury or illness. When you and your partner have a hard time talking, you may find comfort in a support group. Here you can share feelings about many sexual issues. It’s a good way to talk with other people (or couples) who know what you’re going through. Ask about a support group in your area if you feel this would be helpful to you and your partner. 5

Medicine side effects Some medicines you take after hip surgery (like pain pills and cortisone) may cause: decreased desire trouble getting an erection vaginal dryness

CAUTION If you were taking medicines for any conditions BEFORE surgery, make sure they won't interfere with any of your new medicines.

delayed orgasm Talk with your doctor about the medicines youâ&#x20AC;&#x2122;re taking. Ask if any of them can cause some of these side effects. Don't stop taking any medicine unless your doctor tells you to. If you find that one of your medicines is affecting your desire or ability to be intimate, your doctor may be able to change that medicine. You may also try having sex in the morning before taking your first dose of medicine for the day.

A different path to love If you’re still not sure about having sex, there are other ways you and your partner can find pleasure. If changing your usual routine makes either of you uncomfortable or nervous, talk it over. And remember that you don’t always have to reach orgasm to get pleasure. You may want to just explore each other’s body. As you do this, try to focus on your sensitive areas. Let your partner know what feels good, and find out what he or she likes. This type of “exploring” can be very exciting. Touching, caressing and sharing intimate thoughts are ways of expressing your love for each other. What matters most is that you are both comfortable. As long as you are, you will enjoy one another.

Dislocation (for some)

ball

For the first 3 months after surgery, your new hip is in different stages of healing. This can put you at risk for dislocating your hip. Dislocation occurs when the ball of your new

hip joint comes out of the socket.

Depending on your type of surgery, the muscles around your hip may be weak. As a result, you may be asked to avoid certain positions with your affected leg. If your hip dislocates, you may notice a strange feeling at first. This should be a warning sign to stop what you’re doing. You may also: feel a “pop” feel pain not be able to walk see your affected leg get shorter and turn inward—this may cause pain in your knee or thigh

CAUTION The use of the term "affected leg" means the leg on the side of your new hip.

Dislocated Hip

socket

what to do If your hip dislocates, quickly lie down and apply ice to the area. Then you or your partner should call an ambulance to take you to the nearest emergency room. There, the emergency room doctor will take X-rays and then call your orthopaedic doctor's office to explain what has happened. At the hospital, the doctor will give you some medicine to ease your pain and make you drowsy. Then he or she will decide if they can slip your hip back into place using an X-ray. If not, you may have to go to the OR. It may be necessary to put you to sleep. Once your hip is back in place, you may go home the same day or you may have to stay 1-2 nights.

Position yourself for love Talk to your doctor about any precautions you may have. If they are needed, they may include: avoid bending your new hip more than 90 degrees don’t let your affected leg turn inward— keep your knees about shoulder-width apart

DON'T (posterior hip precautions)

don’t cross your legs don’t twist your body The next five pages show sexual positions that can help you avoid pain during sex and lessen the chance that you could dislocate your hip. If any of these positions seem strange for you and your partner, talk about them. You may be surprised what your partner is willing to try to help make it better for you. Ask your doctor or nurse to check ( ) which of the following positions may be

Don’t bend at your hip past 90°.

best for you.

Don’t let your knee move inward past your navel.

Don’t turn your feet in or out.

patient on bottom/partner on top This position is often what works for both male and females and seems to be the most comfortable. When using this position, make sure to:

avoid bending your new hip more than 90 degrees keep your affected leg out to the side make sure your toes donâ&#x20AC;&#x2122;t point inward place a pillow under the thigh of your affected leg (if it makes you feel more comfortable) try to move your affected leg as little as possible

affected leg

patient on top/partner on bottom This position works well for male patients. If you are rolling from the bottom position onto the top, be careful not to turn your affected leg inward toward your other leg. When using this position, make sure to: avoid bending your new hip more than 90 degrees keep your legs shoulder-width apart keep your toes from pointing inward try to move your affected leg as little as possible not strattle your partner â&#x20AC;&#x201C; if you are on top.

sitting position This position works well for male patients. You should be careful to

avoid letting the knee of your affected leg turn inward past your navel (belly button). Make sure to use a sturdy chair for this activity. Donâ&#x20AC;&#x2122;t use this position on a bed or the floor. When using this position, also make sure to: avoid bending your new hip more than 90 degrees sit on a folded blanket, if you need to, to keep your hips positioned higher than your knees avoid twisting the knee on your affected leg inward place a pillow behind your lower back and lean back slightly not bend your upperbody forward

affected leg

side lying position This position works well for most patients. When using this

position, you should lie on your unaffected side. You should also do the following: avoid bending your new hip more than 90 degrees women should put at least 2 pillows between their legs to keep their new hip positioned safely or to support their injured partnerâ&#x20AC;&#x2122;s affected leg men should place their affected leg on top of their partnerâ&#x20AC;&#x2122;s legs and keep it there to support the new hip

standing position This position works well for male and female patients. Make

sure that whatever you are pressing against for support is stable so you don’t fall. A counter top, table top or foot board may be safe choices (Make sure whatever you are pressing against is high enough.) When using this position: avoid bending your new hip more than 90 degrees keep your legs shoulder-width apart make sure your toes don’t point inward or outward stand with full support on your feet– do not over extend. affected leg

CAUTION This position should not be done until the hip is fully healed.

Questions for your doctor Donâ&#x20AC;&#x2122;t be shy about asking questions that will help you feel comfortable about resuming sex. The questions on the next page are a good place to start. Add your own questions as well. Sex is an important part of your life. While you need to learn and follow the guidelines to avoid problems after hip replacement surgery, you also need to know itâ&#x20AC;&#x2122;s possible to have a healthy, active sex life with your new hip!

Talk it over Take time now while your thoughts are fresh to write down any questions you want to ask your doctor. Here are a few to help you get started: Do I have any precautions?

When will I be able to safely have sex again?

Which positions are the best for me to use?

Will any of the medicines I’m taking affect my ability to have sex?

–If so, which one(s)?

–Can I take something else? If so, what? If not, is it OK to wait to take it until I’ve had sex?