flat stomach after a hysterectomy

Can I Get a Flat Stomach After a Hysterectomy?

Hysterectomies are one of the most common surgeries received by women in the modern world. 

According to the most recent data available by the CDC, about 10% of all women in the U.S. between the ages of 40 and 44 have had a hysterectomy. This type of surgery is performed for a variety of reasons. It may be that the woman has a condition such as endometriosis or uterine fibroids and all other treatments have failed. Sometimes, the woman and/or her partner do not wish to have any more children and view a hysterectomy as a permanent type of birth control. 

There are four basic types of hysterectomy, categorized according to their respective surgical techniques:

  1.  abdominal hysterectomy (AH)
  2. vaginal hysterectomy (VH)
  3. laparoscopic hysterectomy (LH)
  4. robotic-assisted hysterectomy (RH)

Research has shown that recovery time for a vaginal hysterectomy is generally shorter than recovery time for abdominal hysterectomy or laparoscopic hysterectomy, due primarily to the minimal incisions of a VH. 

We should also distinguish between total, partial, and radical hysterectomies. A total hysterectomy removes the uterus and cervix, a partial hysterectomy removes the uterus and leaves the cervix, and a radical hysterectomy removes the uterus, cervix, fallopian tubes, and ovaries, as well as the upper part of the vagina and lymph nodes along with possibly some adjacent tissue from the pelvic cavity.

Recovery after a hysterectomy

Hysterectomy recovery is no joke. Typically, a woman recovering from this type of surgery will experience a variety of challenges. The basic timeline given by medical professionals for initial hysterectomy recovery is as follows:

0-2 weeks: rest and recovery

Initial hysterectomy recovery involves a lot of bed rest. When the patient feels ready, she may do some gentle movements like walking.

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2-6 weeks: recovery and rehabilitation 

After 2 weeks of rest, pain should have receded and many women may start to resume their normal activities. But the abdominal incision will still be healing, and the patient will experience more muscle weakness and general fatigue than usual—daily life will be more difficult than usual.

If she feels ready and is cleared by her doctor, she may start to incorporate more gentle abdominal strengthening exercises, mild aerobic activities, and stretches. The goal should be to strengthen pelvic floor muscles and abdominal core muscles.

6-8 weeks and afterward: return to normal exercise and daily life activities

Assuming the patient is recovering at a normal rate, they may start to return to normal life and unrestricted activities by 2 months after surgery. This may be the time a patient starts to wonder if she will be able to regain a flat stomach and lose the belly pooch that often occurs after a hysterectomy.

Basic guidelines for getting a flatter stomach post-hysterectomy 

There are two general strategies for reducing the rounded belly that many women experience after a hysterectomy: abdominal exercises and nutrition.

Exercises to strengthen pelvic floor muscles and abdominal muscles

Modified pelvic tilt 

Start with bent knees and feet flat on the floor, facing the ceiling. Place one hand under your lower back and one on your stomach. Tilt your hip bones up towards your head. This will cause your lower back to come closer to the floor.  Tighten your abdominal muscles and buttocks to support the downward pressure. Maintain this clench for 5 seconds, release it, and repeat.

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Knee roll

You can do this one in bed before you get up to begin your day. Start with your hands spread out at your sides with your palms down and knees bent.

Tighten your abdominal muscles and twist your legs to one side, trying to press your outer leg to the side of the bed.

Shift back to the original position, then roll your knees to the other side before moving back to the original position again.

Modified sit-up

This is a progression after you’ve practiced the pelvic tilt and knee roll.

With your hands cradling the back of your head, lift your shoulders and head — use your core muscles to lift your torso, not your arms.

Hold on for a few seconds, and gently bring your head back down. Your lower back should stay flat on the floor.

Exhale softly with each lift, then relax as you lower your head. 

Diaphragmatic breathing

Deep belly breathing is another gentle core-strengthening activity that you can practice. Watch this video from Girls Gone Strong for more details.

Nutrition strategies for a flatter stomach

It’s common to have a belly pouch after a hysterectomy. This is likely partly due to anatomical modifications that were made during the surgery, partly due to hormonal fluctuations that can occur due to the changed activity of estrogen after the removal of your uterus, and partly due to fat around the midsection.

Nutrition is the best way to reduce fat around the midsection. It’s important to realize that nutrition can’t change the anatomical modifications that were made during the surgery, and it will likely only have small effects on your sex hormones. But it can possibly reduce your fatty pooch to some extent.

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 Have a small calorie deficit

Reducing calories from either fat or carbs, so that you have a small deficit between the calories you take in through diet and the calories you expend through physical activity, is the most sure-fire way to lose body fat.

Eat sufficient protein

Research shows that it’s very important to eat sufficient protein at all times, but especially when eating in an overall caloric deficit. This will help ensure that you maintain or even build muscle mass, while simultaneously losing fat. A good place to start is to eat at least 1 gram of protein per pound of body weight.

Be consistent

Losing fat takes time, just like it takes time to put on body fat. Depending on how much extra body fat you have, you will have to maintain a calorie deficit for a sustained period of time. You would do well to think of eating healthy as a lifestyle, not as a month-long crash diet. 

As you’ve learned, hysterectomy recovery is a long and difficult road. But if you incorporate the strategies in this article, along with the advice of your doctor, you should be able to regain your health and vitality. 

Bethany Stewart

Bethany Stewart is a certified Primal Health Coach with a focus on health optimization and body recomposition. She has a passion for strength training and loves to be outside, preferably hiking in the woods. When she’s not learning and writing about health and fitness, she’s probably hanging out with her husband and toddler or watching The Office.

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