You’re likely here because you’ve either just had the surgery or you’re staring down a surgical date on the calendar, and someone—a friend, a forum post, maybe a vague TikTok—mentioned that you might still bleed. It sounds like a glitch in the system. The whole point of a hysterectomy is to remove the uterus, right? No uterus, no lining to shed. No lining, no period.
But biology is messy.
Honestly, the short answer is usually "no," but for a specific group of people, the answer is a frustrating "kinda." While a total hysterectomy shuts the door on menstruation forever, a supracervical hysterectomy leaves a tiny window open. It’s called a "mini-period," and if your surgeon didn't give you the granular details, it can be a total shock to see blood in your underwear three months post-op.
The Anatomy of Why You’re Still Bleeding
To understand can you have periods after a hysterectomy, you have to look at exactly what was taken out. Not all hysterectomies are the same.
If you had a total hysterectomy, the surgeon removed the entire uterus and the cervix. In this scenario, the vagina is closed off at the top—doctors call this a vaginal cuff. Without a cervix and without a uterine body, there is physically no endometrial tissue left to respond to hormones. You shouldn't see a drop of blood once you've healed.
However, many people opt for a supracervical (or subtotal) hysterectomy. This is where the surgeon removes the upper part of the uterus but leaves the cervix intact. Why? Some believe it helps with pelvic floor support or maintains sexual sensation, though the medical literature, like studies published in the Journal of the American Medical Association (JAMA), often shows no significant difference in long-term outcomes compared to total hysterectomies.
Here is the kicker: the cervix is made of the same stuff as the uterus. It can contain trace amounts of endometrial lining. If your ovaries were left behind—which is common for younger patients to avoid immediate surgical menopause—those ovaries still pump out estrogen and progesterone every month. Those hormones find that tiny bit of tissue left on the cervix. The tissue thickens. Then it sheds.
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You get a mini-period. It’s usually light. Maybe just some spotting for a day or two. But it’s a period nonetheless.
Ovaries: The Engines That Keep Running
One of the biggest misconceptions is that a hysterectomy automatically means menopause. It doesn't.
If your ovaries are still in your body, you are still cycling. You’ll still get the hormonal ups and downs. You might get the bloating, the breast tenderness, and the "period flu" or mood swings. You’re essentially having a "silent period." Your brain doesn't know the uterus is gone; the pituitary gland keeps sending signals to the ovaries to drop an egg. The egg just gets absorbed by the body.
If you have your ovaries and your cervix, that monthly hormonal surge is exactly what triggers the bleeding. Dr. Mary Jane Minkin, a clinical professor at Yale School of Medicine, has noted that about 7% to 11% of women who undergo supracervical hysterectomies will experience these cyclical mini-periods. It’s not a "failure" of the surgery; it’s just a biological byproduct of keeping the cervix.
When Bleeding Is Actually a Red Flag
Let’s be clear. If you had a total hysterectomy (cervix gone) and you are bleeding months or years later, that is not a period. It can't be.
Post-hysterectomy bleeding in these cases needs a doctor’s eyes on it immediately. Sometimes it’s something simple like vaginal atrophy. As we age or if we enter menopause, the vaginal walls get thin, dry, and brittle. They can tear or bleed easily. This is super common but also very treatable with localized estrogen.
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Other times, it might be:
- Granulation tissue: This is basically scar tissue at the top of the vaginal cuff that didn't heal quite right. It’s vascular and bleeds easily. A doctor can usually fix this in the office with a little silver nitrate.
- Infection: Pelvic inflammatory issues or even severe localized infections can cause spotting.
- Cancer: It’s the thing nobody wants to talk about, but new bleeding after the removal of the uterus can occasionally signal a recurrence or a new primary cancer in the vagina or vulva.
- Fallopian tube prolapse: Rare, but sometimes a fallopian tube can peek through the vaginal cuff.
The Menopause Factor
If you had your ovaries removed during the surgery (an oophorectomy), you are in surgical menopause. Period. Full stop. You should not have any cyclical bleeding. If you do, it’s not a period; it’s a medical issue that needs a workup.
For those who kept their ovaries, menopause will happen eventually. Interestingly, research suggests that women who have had a hysterectomy might enter menopause a few years earlier than they would have otherwise. This might be because the surgery disrupts the blood flow to the ovaries just enough to shorten their lifespan. Once you hit that "natural" menopause, even the mini-periods from a supracervical hysterectomy will dry up and disappear.
Real Talk: The Emotional Side of "No Period"
Most people are thrilled to ditch the pads and tampons. Especially if you were dealing with endometriosis, fibroids, or adenomyosis that made your life miserable for decades.
But for some, the total absence of a cycle feels... weird. It’s a loss of a monthly rhythm. If you’re one of the people who ended up with mini-periods after a supracervical hysterectomy, it can feel like you were cheated out of the "freedom" you were promised. It’s okay to feel annoyed by that.
On the flip side, some find comfort in the mini-period. It’s a sign that their hormones are still doing their thing. It’s a very personal reaction.
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How to Manage Expectations Post-Op
If you are still in the planning stages, talk to your surgeon about the cervix. If your goal is 100% "no more periods ever," you need to discuss a total hysterectomy. If you decide to keep the cervix for other reasons, ask them about "cauterizing the endocervical canal." This is a technique where they burn the lining of the cervix to try and prevent mini-periods from happening. It’s not 100% guaranteed, but it significantly lowers the chances.
If you’ve already had the surgery and you’re bleeding, track it. Is it every 28 days? Or is it random? Random bleeding is more concerning than cyclical bleeding.
Actionable Steps for Post-Hysterectomy Bleeding
If you're noticing blood and you're not sure if it's a period or a problem, do the following:
- Check your surgical report. Confirm if your cervix was removed. You’d be surprised how many people aren't 100% sure which type of hysterectomy they had once the "surgical fog" clears.
- Monitor the timing. Use a tracking app. If the bleeding happens like clockwork alongside breast tenderness or PMS symptoms, it’s likely a mini-period (if you have a cervix).
- Inspect the flow. Is it bright red? Brown spotting? Are there clots? Heavy bleeding (soaking a pad in an hour) is always an emergency post-hysterectomy.
- Schedule a "Cuff Check." If you had a total hysterectomy, ask your gynecologist to check the vaginal cuff for granulation tissue. It's a five-minute fix.
- Review your HRT. If you're on Hormone Replacement Therapy, your dosage might need adjusting. Sometimes the balance of estrogen and progesterone can cause "breakthrough" bleeding if you still have a cervix.
The bottom line: can you have periods after a hysterectomy depends entirely on the presence of your cervix and the activity of your ovaries. It’s rare, it’s usually light, but it’s a biological possibility that your surgeon might have glossed over. If you're ever in doubt, or if the bleeding is heavy or painful, get a pelvic exam. Your peace of mind is worth the co-pay.
Next Steps:
- Contact your surgeon’s office to request your "Operative Note" to see exactly what was removed.
- Start a 3-month symptom journal to identify if your bleeding follows a hormonal cycle.
- If bleeding occurs after intercourse, schedule a physical exam to rule out vaginal cuff issues or atrophy.