Purpose: This study examined the relationship between sexual changes and adjustment and identified the factors which affect adjustment after a hysterectomy. Method: The subjects were 89 women under 50 years of age registered at gynecology departments of general hospitals in Seoul. Result: 60.7% of the women restarted coitus during six weeks to three months post operation. They felt a decrease in vaginal secretions (68%), and abdominal and pelvic pain (59.8%), but2/3 of them didn't change the frequency of coitus and level of orgasm. With respect to the adaptability of the sexual life, there was a significant difference in the time to restart coitus, lack of vaginal secretions, abdominal and pelvic pain, change of frequency of coitus, experience of orgasm, importance of sex and avoidance of coitus, according to job, income, and health condition. Conclusion: It is appropriate to restart coitus six weeks to three months after surgery and preliminary information should be given to patients after surgery as abdominal and pelvic pain could be relieved after twelve months. Also, sexual adjustment can be improved if they can recognize the changes after surgery from sexual life before surgery.