Most people can have sex again after a hip replacement once they feel comfortable, commonly around FOUR to SIX weeks after surgery. Some surgeons are happy for you to start sooner if pain allows. If you can walk around the house, get in and out of bed without help and your wound has healed, you are probably close.
The one real risk in the early weeks is dislocation, where the ball of the new hip slips out of its socket. It is uncommon, affecting roughly 1 to 2 in 100 people, and it is most likely in the first few weeks. Which movements to avoid depends on how your surgeon reached the joint.
The safest position early on is simple: the person who had surgery lies on their back with legs slightly apart, and the partner takes the more active role. This works for women and men.
Your surgeon’s instructions come first. If they differ from anything here, use theirs.
When can you have sex after hip replacement?
There is no single date. Timings vary between surgeons, so treat these as a typical range, not a rule.
- Weeks 0 to 2: Your wound is healing and you are tired and sore. Most people have no interest in sex yet, and that is normal.
- Weeks 2 to 4: Some people feel ready. If your surgeon agrees and pain allows, gentle sex in one of the safe positions below is reasonable.
- Weeks 4 to 6: The most common time to start again. You are walking better, sleeping better and need fewer painkillers.
- After about 6 weeks: Many surgeons relax or lift your hip precautions at the six-week review. Most people are back to their normal sex life by about three months. See hip replacement recovery week by week
The OrthoInfo guide to activities after total hip replacement gives the same advice: many people resume within several weeks, after checking with their doctor.
Which hip movements to avoid
The movements to avoid depend on your surgical approach, meaning the route your surgeon took to reach the joint. If you are not sure which you had, check your discharge notes or ask.
- Posterior approach (from the back): Don’t bend your hip past 90 degrees, a right angle, so your knee should not come up higher than your hip. Don’t cross your legs, and don’t turn your knee inward. See hip replacement precautions
- Anterior approach (from the front): Don’t push the operated leg far back behind you, and don’t turn it outward. See anterior vs posterior hip replacement
- Either approach: Avoid twisting through the hip and sudden, forceful movements. Stop if you feel sharp pain.
The best positions after hip replacement
These positions keep the new hip in its safe range. They suit both women and men who have had the operation.
- On your back, legs slightly apart: The person who had surgery lies flat, knees straight or only slightly bent, legs about shoulder width apart. The hip stays well under 90 degrees and does not twist. The partner takes the more active role. This is the safest choice for most people early on.
- On your side, operated hip on top: Lie on your non-operated side with a firm pillow between your knees. The pillow stops the top leg from crossing over or rolling inward. Keep the hips only slightly bent. This position also tends to suit people after the posterior approach.
- Pillows for support: A pillow under the knees, or one along the outside of the operated leg, stops it rolling in or out without you having to think about it.
- Everything else, later: Positions that need deep hip bending, kneeling or a lot of twisting are best left until your surgeon lifts your precautions, usually after about six weeks.
Keep your new hip in its safe range, and let your partner do the moving.
What helps
- Talk with your partner first: Pain medicines and tiredness can lower desire, and partners often worry about hurting you. Saying what feels fine and what doesn’t takes the guesswork out for both of you.
- Time your pain relief: Taking your usual painkiller 30 to 60 minutes beforehand makes it easier to relax.
- Use a firm surface: A firm mattress gives you more control than a soft one that lets the hip sink and roll. See sleeping after hip replacement
- Go slowly and stop if it hurts: A dull ache is fine. Sharp pain, or a feeling that the hip is giving way, means stop and change position.
- Keep up your exercises: Stronger hip and thigh muscles hold the joint steady and make every position easier. See exercises after hip replacement
What’s normal
- Low desire in the first weeks: Painkillers, poor sleep and tiredness all reduce interest. Desire usually returns as you recover and come off the medicines.
- A mild ache afterward: Some hip or thigh soreness the next day that settles within a day is normal.
- Nerves the first time: Most people are worried about dislocation the first time. Using a safe position and going slowly settles that quickly.
- A better sex life than before: Many people report that sex is better after surgery, because the arthritis pain that limited them is gone.
Go to the emergency department if
- You hear or feel a clunk or pop in the hip, followed by severe pain.
- You suddenly cannot put any weight on the leg.
- Your leg suddenly looks shorter or is turned in or out. These are signs of a possible dislocation.
- You become short of breath or have chest pain, which can mean a blood clot has reached the lung.
Call your surgeon today if
- You have new pain, swelling, warmth or tenderness in your calf, which can be a sign of a blood clot. See blood clot after surgery
- Your wound becomes red, hot or starts leaking fluid, or you develop a fever.
Mention it at your next review if
- Sex is still painful three months after surgery.
- Low desire or erection problems carry on after you have stopped your pain medicines.
- You are not sure which approach you had or which precautions still apply to you.
For a few weeks your new hip has a safe range to respect, but once it heals it should get in the way of your sex life far less than your arthritis did.