This article is part of the Ultimate Guide to Hip Pain Relief.

Many questions go through your mind when you’re thinking about scheduling joint replacement surgery, but you might not feel comfortable talking about some topics with your doctor.

If you’ve been wondering what sort of restrictions you might have to think about when you return to intimacy after hip replacement, this blog post is for you.

IBJI recently chatted with Jeffrey Goldstein, MD, a board-certified orthopedic surgeon and expert on adult hip and knee reconstruction about everything from how soon you can return to sexual activity (and how you can have intercourse without getting hurt). His responses—below—have been edited and condensed for space.

Frequently Asked Questions About Sex After Hip Replacement

How do you know if it's safe to have sex again after hip surgery?

Dr. Goldstein: Early after hip replacement surgery, you are at the highest risk of dislocation when returning to activities, including intercourse. This is why I initially tell my joint replacement patients to avoid sexual activity to prevent pain and discomfort.

In general, you can expect to feel ready to return to sexual activity around four to six weeks after your hip surgery. For most patients, their pain has subsided enough by this time that it makes starting up sexual activity possible. For some people, though, they will need to follow temporary precautions to prevent injury.

Which sex positions are the best (and provide the most support) after hip replacement surgery?

Dr. Goldstein: For everyone, I recommend sticking to positions that won't cause pain or increase the risk of dislocation.

Post-op Sex Recommendations for Men

It's generally safe to position yourself on top or bottom. Ideally, in this scenario, you'll also want to spread your legs apart and point your toes outward.

If you're having sex in a standing position in front of or behind your partner, you must make sure you are supported.

You can also have sex from a seated position if you sit back without flexing your hips greater than 90 degrees. You should avoid bending over your partner with your hips and knees flexed more than 90 degrees.

You can also safely have sex while lying on your surgical hip side if this position is not painful. If you lie on your non-surgical side, make sure your surgical side is propped up and supported with pillows to avoid twisting and internally rotating (crossing the midline).

Post-op Sex Recommendations for Women

No matter the position, the most important thing to remember is you want to avoid flexing your hips more than 90 degrees during sex.

Given this limitation, some options—like sitting on top of your partner in a chair or bed—are risky after hip surgery. This also makes it unsafe to have sex in positions where you are bent over and on your hands and knees.

Generally speaking, the safest position for women who have had a hip replacement is missionary. When having sex in this position, be sure to spread your legs apart and point your toes outward.

You can also have sex safely while resting on your surgical side, as long as it is not painful. As it is with men, you can also safely have sex while lying on your surgical hip side if this position doesn't cause pain. If you lie on your non-surgical side, make sure your surgical side is propped up and supported with cushions or blankets to avoid twisting and internally rotating (crossing the midline).

Patient Success Story: Learn how Marlene went from battling hip pain to walking 10Ks

Do medication or painkillers prescribed after hip replacement surgery cause impotence or lessen your sex drive?

Dr. Goldstein: Patients frequently require temporary pain medication, like narcotics, after having hip surgery. One side effect of narcotic pain medications is reduced production of testosterone and other hormones, which can temporarily reduce sex drive and sexual performance. Fortunately, this typically improves once you stop taking the medication.

Some patients also feel tired and out of sorts for a couple of weeks after their joint surgery, and this can make them temporarily disinterested in sex, too.

Will having hip replacement surgery make it harder for you to get pregnant and have a baby?

Dr. Goldstein: Although most hip replacement surgery patients aren't of childbearing age, there are scenarios where younger patients require the procedure.

The good news is that pregnancy and childbirth are not affected by hip replacements. Furthermore, pregnancy and childbirth have been shown not to affect how long a hip prosthesis lasts.

Metal-on-metal bearing surfaces are generally not advised for younger women who may get pregnant because of the theoretical risk of metal ion production in the bloodstream affecting a fetus; however, the data on this concern is relatively sparse. Nowadays, the vast majority of orthopedic surgeons avoid metal-on-metal bearing surfaces altogether.

Recovery Support After Hip Surgery

Trust IBJI When You Need Hip Pain Relief

Whether you are looking for non-surgical treatment options to eliminate stiffness and aches or considering having joint replacement surgery to stop your pain, IBJI's hip specialists can help.

Ready to get started? Let's figure out what's causing your hip pain together. Schedule online today with one of our orthopedic doctors, and get a personalized, comprehensive plan for treating your hip pain.

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