one step logo
Back to Blog

Sex After Hip Replacement Surgery

Sex is an important topic, one that impacts everyone. Unfortunately, it’s often overlooked by practitioners and patients alike who are either preoccupied with the other pressing concerns of surgery or a bit too shy to engage in a sensitive and potentially embarrassing topic.


Nevertheless, the question of when to have sex, which positions are safe and which to avoid, is really important.


To begin, if you’re reading this you’ve probably been negotiating the challenges of sex for a while. Most people who end up having hip replacement surgery spend months (if not longer) coping with pain, stiffness, and other discomforts which can adversely impact your libido. Such a degree of pain could easily make the thought of a carefree romp in the sheets seem pretty intimidating. Plus, beyond the physical discomfort, many people are just too preoccupied dealing with chronic health conditions and the anxiety of an upcoming surgery to be in the mood for sex.


Alternatively, maybe the surgery is behind you but you’ve been slowed down by your surgeon’s movement restrictions. Maybe you’re dealing with dampened desire from medications and post-surgery fatigue. All of this is a recipe for a stagnating love life, personal performance frustration, shame, and intimacy issues with your partner.


“Our sex lives and our desire are profoundly impacted by our physical health and our emotional state, that is not something we should judge ourselves for.”


The first thing to keep in mind is that all of this is completely normal. Really. Completely normal. Sit with that for a minute. Maybe even take a moment and read that sentence out loud. Our sex lives and our desire are profoundly impacted by our physical health and our emotional state, and that is nothing we ought to judge ourselves for. The most important thing you can do for yourself is to accept where you are at, be aware of the impact that these circumstances are having on your life, and forge some open conversations about it with your partner, once you’re both ready to do so. This can be a sensitive subject for many, so be gentle with each other.


So, what about your physical health post-surgery? Well, good news! There’s absolutely no reason why you shouldn’t get “back in the saddle” once you’re feeling up to it. In fact, research shows that when you’re fully recovered, your sex life may even significantly improve! Just like pain can hinder our desire, the absence of pain can turn us back on! Are you feeling better and able to move more freely? Maybe it’s time to celebrate your recovery a bit! 😉


Not there yet and wondering when? We’ve found that most people feel ready about 6-8 weeks post-surgery, as it does take about three months for the soft tissue around your new joint to heal. Those first few romps might feel delicate – so go slow at first! Try and find positions that support your hips and even consider letting your partner be the more active participant as you get used to things. Keep in mind that your surgeon’s operative approach also impacts recovery time and the timeline to return to sexual activity. Patients who’ve had the anterior approach will generally be allowed to return to these activities sooner and with fewer restrictions.


“Those first few romps might feel delicate so go slow at first.”


Post-operative restrictions are often different during sex for men and women. As such, we recommend beginning with the “missionary” position, which is the safest way to go and allows you to lie down. Another position that works well for men and women post-op is the standing position. When both people are standing, have your partner bend slightly at the waist with the other approaching from behind. A third option is laying on the operated side (assuming there’s no pain), affording this side the opportunity to do the least amount of work.


Are you worried about dislocating your hip? There’s not much evidence sex is the culprit. Robert Nickodem, MD, an orthopedic surgeon at the Cleaveland Clinic, describes, “I have never had a patient dislocate a hip from having sex following a hip replacement.”


Are you feeling reassured and ready for the deed? Great! Maybe take a minute to plan your positions with your partner ahead of time, double-checking that you’re not doing anything restricted.


Also, steer clear of the following movements:
• Bending your hip more than 90 degrees
• Crossing your legs
• Rotating your hip (hip twisting) internally


Sex is an essential component of our physical, mental, and spiritual well-being, so don’t feel like you have to leave it off your recovery list. Integrating sex back into your life is a part of your recovery from a total hip replacement, so try and embrace feeling comfortable talking to your surgeon, raise any concerns, and make sure you know what you need to know in order to reclaim and rebuild your sex life.