A hysterectomy is a surgical procedure involving the removal of the uterus, the organ that holds the endometrial lining that sheds monthly. The type of hysterectomy performed determines which anatomical structures are removed, significantly impacting whether cyclical bleeding continues. A partial hysterectomy, also known as a supracervical or subtotal hysterectomy, removes the main body of the uterus but intentionally leaves the cervix in place. This surgical choice stops a true period while introducing the possibility of a different, much lighter form of cyclical bleeding.
What a Partial Hysterectomy Changes
A partial hysterectomy removes the uterus, the organ responsible for the monthly shedding of the endometrial lining. The procedure is defined by the preservation of the cervix, the lower, narrow part of the uterus that projects into the vagina. The ovaries are typically left intact during this operation unless there is a separate medical reason for their removal.
Leaving the ovaries in place means the body continues to produce the reproductive hormones estrogen and progesterone in a cyclical pattern. These hormones regulate the menstrual cycle, including the monthly buildup and shedding of the uterine lining. The continuation of this hormonal cycle is why some individuals may still experience premenstrual symptoms like breast tenderness or mood changes, even without the uterus.
Why True Menstruation Stops
A true menstrual period is the monthly process of the body shedding built-up endometrial tissue and blood through the vagina. This tissue is generated inside the uterus in preparation for a potential pregnancy. When the egg is not fertilized, hormone levels drop, signaling the uterus to slough off the lining.
A partial hysterectomy removes the entire upper portion of the uterus, eliminating the organ that contains the vast majority of the endometrial lining. Without the uterus, there is no significant lining to build up and subsequently shed. Therefore, a full, traditional period ceases immediately after the surgery.
Understanding Cyclical Spotting (The Stump Period)
Some individuals may experience light, cyclical bleeding, often referred to as a “stump period.” This phenomenon occurs because the preserved cervix sometimes contains a small amount of residual endometrial tissue. This tissue is a remnant of the uterine lining located very close to the cervical canal.
Since the ovaries remain and continue cyclical hormone production, this residual tissue responds to the same hormonal fluctuations. As hormone levels dip at the end of the monthly cycle, this tiny patch of tissue can shed, leading to light spotting or a pinkish-brown discharge. This bleeding is usually minimal, often requiring only a panty liner, and is predictable, occurring around the time a period would have been expected. The incidence of this cyclical spotting is reported to occur in up to 25% of cases following a supracervical hysterectomy.
Identifying Abnormal Post-Operative Bleeding
Expected light cyclical spotting must be distinguished from bleeding that signals a potential complication. Normal post-operative vaginal discharge and light spotting can occur for up to six weeks as the surgical site heals. This discharge should become progressively lighter over time and is part of the recovery process.
Bleeding that is heavy, bright red, or requires soaking through pads is considered abnormal and requires immediate medical attention. Other concerning indicators include the sudden onset of heavy bleeding months or years after the surgery, or any bleeding accompanied by severe pain, fever, or a foul-smelling discharge. Any bleeding that resembles a full menstrual period suggests the need for medical evaluation.