Any information in this column is purely educational and should not be used as medical advice.
An interview with FOLX clinician Kaity (they/them) PMHNP-BC CNM draws upon their prior experience working in reproductive health. Particularly, we dive into how abortion (whether it's a surgical/medical abortion or via an abortion pill) can affect your sex life in the recovery period.
How long after an abortion can you have sex?
There isn't any medical consensus on when it's safest or recommended to have sex after an abortion. The "general" guideline used to be after two weeks or until vaginal bleeding has stopped, but no clinical evidence exists to support this. There's a stigma around having sex while bleeding, which is likely where this guidance came from. However, most healthcare providers will agree that there isn't a medical reason to avoid sex if you feel ready.
For some people, bleeding will subside quickly after an abortion or only last a few days. Some people will barely experience any bleeding, regardless of the type of abortion. With that said, bleeding is normal; typically, bleeding stops anywhere from two to six weeks after an abortion.
Keep in mind that you can become pregnant again very quickly with your next menstrual cycle after an abortion, even if you're bleeding. It's possible to become pregnant again within two to four weeks after an abortion.
If your goal is to avoid an unwanted pregnancy, I would always recommend some type of pregnancy prevention (like birth control pills or other forms) right away. Abortion clinics often offer this at the time of your abortion if you want it. If someone has a surgical abortion and wants a longer-acting method like an intrauterine device (IUD), this can be placed in most scenarios at the same time as the procedure. Talk to your abortion provider (or follow up with your primary care provider) for birth control options if that's something you're interested in.
For those interested in discussing contraception with an LGBTQ+ competent clinician, book a virtual healthcare visit here with FOLX Health.
How long after an abortion can you receive oral sex?
There isn't any medical reason that you should avoid receiving oral sex for any amount of time after an abortion. You may be bleeding after your abortion, but this is also not a medical reason to avoid receiving oral sex.
How long after an abortion can you receive penetrative vaginal/front hole sex?
The same answer as above! There isn't any medical reason that you should avoid receiving penetrative vaginal/front hole sex for any amount of time following an abortion.
How long after an abortion can you receive anal sex?
There isn't any medical reason that you should avoid anal sex after an abortion for any time period. The increased uterus size from pregnancy can sometimes cause discomfort from anal sex that was comfortable for you before, so adjusting positions or going slow can make sense.
Do recovery periods vary for surgical versus pill abortions? Does one require a longer wait time to have sex over another?
Recovery periods after both surgical and medication abortions are similar.
However, since surgical abortion procedures are typically "done" and complete as soon as you have them, there is a different recovery timeline than with pill abortions. This also depends on how many weeks pregnant you are, as surgical methods change depending on the number of weeks. For surgical abortions conducted between 14 to 20 weeks of pregnancy, some clinicians will include additional methods before the surgical procedure, such as laminaria—small seaweed-based devices that open the cervix—or ask that you take misoprostol (a pill that helps stimulate uterine contractions) before the surgical procedure and wait a few hours to also help open the cervix.
After 20 to 24 weeks, surgical abortions are often one to two day procedures. Your recovery after surgical abortion also depends on whether you need or choose pain or sedation medication with your procedure. Sometimes, these medications require additional rest or recovery time and a ride home from a friend or someone else.
With pill abortions, you will most typically take the first pill, mifepristone, and then take your misoprostol (usually four pills) by placing them in your cheeks and letting them dissolve. This is done at home. Instructions vary, but you can take these often within six hours of your mifepristone if desired or when you feel ready. The second set of pills will cause moderate cramping and bleeding. This often starts within one to four hours, but can take 24 hours for some people. Once cramping and bleeding starts, the pregnancy often passes within four to six hours. Since the pills are a slightly longer process, it could be said that recovery is "longer," but once the abortion is complete, recovery time is the same. A small percentage of the time, the "pill" abortion won't work for some people; they will either need to take more misoprostol pills or be recommended for a surgical abortion.
The period of time until you can have sex after either should be the same. If you're having an abortion that requires more dilation of your cervix or the pregnancy was more than 20 to 24 weeks, your risk of infection may be slightly higher if you have sex right away or put anything in your vagina. You may want to wait a few days, but again, there isn't any medical consensus or credible research on the recommended timeline.
Penetrative sex should not be painful, although you may have cramps for a few days afterward. Sometimes, while receiving penetrative sex, you'll need to adjust your position or listen to your body as the increased uterus size from pregnancy can sometimes cause different sensations or experiences.
The best process is to focus on how you feel physically and emotionally and listen to your body to know when to resume having sex. It's also recommended to check in with your mental health and overall well-being.
Anything else you'd like to add, clinically speaking?
Abortion is completely normal! Abortion is one of the safest medical procedures that exists, and complications after abortion are very rare. One in four people who can become pregnant have at least one abortion in their lifetime. Because of the stigma around abortion, it can sometimes be difficult to talk about openly with others. Talking about your abortion is something personal only you get to decide. For some, connection to a supportive community and other people who have been through similar experiences can feel important or helpful. Check out the following below for some resources.
Abortion care networks:
Need an abortion? Find a local clinic or other safe options here:
Need help paying for travel to get your abortion?
Want to support abortion care? Check out our Library article, Abortion Funds You Can Support Today.
If you're interested in meeting with an LGBTQ+ specialized clinician about birth control, fertility, and more, schedule a virtual healthcare visit today with FOLX Health.
__
FOLX Health is the first digital healthcare company designed by and for the LGBTQIA+ community. Our services include virtual primary care, gender-affirming hormone therapy including estrogen and testosterone (HRT), mental health care, sexual and reproductive health care, preventive care, and fertility consultations. FOLX memberships give you access to LGBTQIA+ expert clinicians, peer support, thousands of LGBTQIA+ resources, and more. Whether you're lesbian, gay, bisexual, transgender, queer, gender non-conforming, or nonbinary, you can find LGBTQIA+-specialized health care that helps you meet your wellness goals. FOLX Health is health care that's queer all year. Get all the benefits of becoming a FOLX member and sign up today!