Bleeding After a Hysterectomy

How to Know What Is Normal and Abnormal

By Jennifer Whitlock, RN, MSN, FN | Medically reviewed by a board-certified physician | Updated May 19, 2019

Some bleeding after a hysterectomy is normal. In the 6 to 8 weeks following the procedure, a certain amount of bleeding or spotting can be expected. After all, a hysterectomy is a major surgery involving the removal of a significant amount of tissue.

Knowing the difference between normal and abnormal bleeding can help prevent serious complications, including infection and uterine injury.

According to research published in Obstetrics & Gynecology, post-operative infection occurs in 10.5 percent of abdominal hysterectomies, 13 percent of vaginal hysterectomies, and 9 percent of laparoscopic hysterectomies.

Normal vs. Abnormal Bleeding

The key sign that you are healing normally is that the bleeding will begin to decrease in the days following the surgery.

On the other hand, if there is a sudden and significant increase in bleeding, that would be considered abnormal. Bleeding should steadily decrease in the days and weeks following the surgery and should never be excessive at any point in your recovery.

Heavy bleeding during recovery should be reported your surgeon immediately as well as any symptoms of infection or a neurogenic bladder.

When to Call a Doctor

  • If there is bright red vaginal bleeding
  • If you have a temperature over 100.4 F
  • if you have severe nausea or vomiting
  • If the pain is increasing
  • If there is redness, swelling, or drainage at the incision site
  • If you have difficulty urinating or pain with urination

Bright red blood indicates an active bleed. Passing large clots indicates that a large amount of blood has accumulated, often while you are sleeping.

Other Concerns

Bleeding after surgery can lead to anemia, a condition in which the depletion of red blood cells triggers symptoms of fatigue, dizziness, headaches, and easy bruising, Even if there are no overt signs of bleeding, extreme fatigue following surgery should always be looked into.

Lab and imaging tests may be used to confirm the anemia diagnosis and help pinpoint the source of bleeding. The anemia itself may be treated with iron supplements or require a transfusion to restore your red blood cell count (RBC) and prevent complications.

You should be able to return to having sex 6 to 8 weeks after your surgery. Having sex too soon may not only be painful but end up promoting bleeding. If you note any bleeding after having intercourse, be sure to report it to your OB-GYN.

A Word From Verywell

Regardless of whether the bleeding is bright red or not, no amount of bleeding should be considered normal after you've recovered from a hysterectomy. If this happens, call your doctor and schedule an appointment immediately.

The one exception is menstruation in women who have undergone a subtotal hysterectomy. This considered a less-than-undesirable result given that the vast majority of women who have undergone the procedure do not experience this.

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