It’s typical to experience bleeding after a hysterectomy. But that doesn’t mean that all bleeding is normal.
Most people experience bleeding immediately following the procedure and for several weeks afterward. It should get lighter with time.
Abnormal bleeding occurs when vaginal bleeding becomes heavier, appears suddenly, or doesn’t stop. You should discuss any abnormal signs of bleeding with your doctor right away.
Most people will experience some bleeding following the procedure.
It’s typical to expect bleeding for up to six weeks after your procedure as your body heals and the stitches from the procedure dissolve. The discharge may be red, brown, or pink. The bleeding will fade in color and become lighter in flow as time passes.
How much bleeding you experience depends on the type of procedure you have.
Types of hysterectomy
Your doctor can perform a hysterectomy in several ways:
- Vaginal. Your procedure may be done through your abdomen or through your vagina.
- Laparoscopic. Your doctor may use laparoscopic tools to help with the procedure. This means your doctor will perform the operation through small incisions with the help of a camera inserted in your body.
- Robot assisted. Your doctor may perform a robotic procedure. This involves your doctor guiding a robotic arm to perform the hysterectomy with greater precision.
Average blood loss for these types of procedures is 50 to 100 milliliters (mL) — 1/4 to 1/2 cup — for vaginal and laparoscopic surgeries and a little over 200 mL (3/4 cup) for abdominal surgeries.
You may experience a light period for up to a year if you have a partial hysterectomy. This is because you may have remaining endometrial lining in your cervix.
If you have a total or radical hysterectomy, you won’t experience menstrual periods again.
Bleeding that follows a hysterectomy that is heavy like a period, lasts longer than six weeks, gets worse over time, or suddenly occurs could be a sign of a complication.
You may experience abnormal bleeding from the procedure because of a hemorrhage or a vaginal cuff tear. Both of these complications are rare but do cause vaginal bleeding.
It’s possible that you experience vaginal bleeding months or years after a hysterectomy. This may be because of vaginal atrophy or another medical condition, such as cancer. Call your doctor to discuss any bleeding that occurs more than six weeks after your procedure.
A hemorrhage may occur after your surgery. This happens in only a . You’re more likely to experience hemorrhage if you had laparoscopic surgery. It isn’t known why more cases occur after this procedure than others.
Your uterine vessels or cervical and vaginal vessels may be the source of your hemorrhage.
Symptoms of a hemorrhage following your procedure may include sudden or heavier vaginal bleeding.
In a who underwent a hysterectomy, 21 experienced a secondary hemorrhage. Ten had mild bleeding under 200 mL, and 11 had profuse bleeding over 200 mL. One person had a cough and two had fevers. These hemorrhages occurred 3 to 22 days after the hysterectomy.
Vaginal cuff tear
You may also experience vaginal bleeding if your vaginal cuff tears following a total or radical hysterectomy. This occurs in only .14 to 4.0 percent of those undergoing this procedure. It’s more likely to occur if you’ve had a laparoscopic or robotic procedure.
You can experience a vaginal cuff tear any time after your procedure.
In addition to bleeding, symptoms of a vaginal cuff tear include:
- pain in your pelvis or abdomen
- watery discharge
- pressure in your vagina
It’s likely your symptoms will be obvious enough to seek a doctor’s care within a day.
Your vaginal cuff may tear for no reason at all or from having sex, moving your bowels, or coughing or sneezing.
Call your doctor if you experience any abnormal signs of bleeding following your surgery.
Call the doctor if you experience
- bleeding that gets heavier over time
- bleeding that gets darker in color
- bleeding that persists after six weeks
- bleeding that occurs suddenly
- bleeding that occurs with other unusual symptoms
Also call your doctor if you’re nauseous or vomiting, experience discomfort when urinating, or notice that your incision is irritated, swollen, or draining.
When to go to the ER
You should go to the emergency room after a hysterectomy if you have:
- bright red bleeding
- extremely heavy or watery discharge
- a high fever
- increasing pain
- difficulty breathing
- chest pain
Normal levels of bleeding following your procedure don’t require treatment. You can wear an absorbent pad or panty liner during your recovery to contain the bleeding.
There isn’t one single way to treat abnormal bleeding following your procedure. You should consult your doctor for treatment methods based on the causes of your bleeding.
First-line treatment options for a hemorrhage after your procedure include vaginal packing, vault suturing, and blood transfusion.
Vaginal cuff tears can be repaired through surgery. These procedures can be done abdominally, laparoscopically, vaginally, or through a combined approach. Your doctor will recommend a procedure that addresses the cause of the tear.
Forms of abnormal bleeding that occur months or years after a hysterectomy need to be diagnosed and treated by your doctor.
Bleeding is one common symptom after a hysterectomy. In most cases, the bleeding is normal and not a cause for concern.
But sometimes bleeding is a sign of a more serious complication and needs immediate medical attention. Contact your doctor if you suspect the bleeding after your procedure is unusual.