Three months ago, I had a total hip replacement. My doctor has given me the thumbs up for resuming sexual intercourse. What positions are best? Do I still need to avoid full hip flexion and internal rotation?

A recent study from Mayo Clinic reports on advice given patients by surgeons after total hip replacement (THR). Doctors were shown 12 positions used during sexual activity and asked to mark each one as acceptable or unacceptable. They did this for both male and female patients with a THR.

Five positions for men and three for women were agreed upon by 90 percent of the doctors. The best position is standing with the male partner behind the female. The woman is supported by a pillow against a firm object or piece of furniture. Both partners are bending forward but with less than 90 degrees of hip flexion.

Avoiding extreme positions of hip flexion, internal rotation, and adduction (crossing the midline) is still advised. Pillows can be used to help support the body in acceptable positions.