Spotting after a hysterectomy is common for four to six weeks after the surgery. During the procedure, organs are removed from the abdomen, and this requires time to heal. Recovery time will vary between patients, but bleeding should diminish and eventually stop as the body heals.
The key to normal spotting is in volume and type of blood. Spotting refers to a small amount of blood showing up on toilet paper or on undergarments. Discharge after hysterectomy is typically faint pink or brown. Bright red blood is fresh blood coming from a source that is currently bleeding. Significant fresh bleeding is not typical. Heavy bleeding is not considered normal after a hysterectomy and should be discussed with a medical professional.
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If bleeding persists beyond the six to eight-week mark, medical attention may be required to find the source. A subtotal hysterectomy, or removal of only a portion of the female reproductive system, may not cause menstrual cycles to stop. If this is the case, regular monthly bleeding will continue until menopause.
A total hysterectomy often includes removal of all female reproductive organs, including the uterus, fallopian tubes, and ovaries. The cervix is most often sewn closed. During intercourse, spotting is common if the cervix is still healing. Vaginal dryness during intercourse can also cause spotting after a hysterectomy.
A gradual reduction in blood volume followed by a sudden increase in bleeding could be a sign of medical emergency. In this case, patients should see an emergency medical professional or seek an immediate appointment with a gynecologist. A pelvic exam could be performed to rule out tearing of the vagina or cervix. Other medical procedures, such as a computerized topography (CT) scan, may also be ordered.
Some women choose to wear protective pads after a hysterectomy to absorb spotting. Sanitary napkins and panty-liners are considered safe for use after surgery. Tampons, however, are not typically recommended by gynecologists or surgeons, especially if the cervix was sewn closed during surgery.
Various check-up appointments may be required after a hysterectomy. During these, it is important to speak with the medical professional about spotting, blood volume, and the color of blood being passed. Keeping a record of the bleeding may help a patient to remember how frequent it is and how much blood passed to be reported at the next check-up.