Post-Myomectomy: Changes in Menstrual Cycle and Delays

Q: Post-Myomectomy: Changes in Menstrual Cycle and Delays

Hello： Medications, stress, and many other factors can cause menstrual issues. <br>It is important for you to visit the clinic for a consultation with a physician, who can examine you and identify the underlying cause in order to provide appropriate management or treatment as soo

After fibroid surgery, menstruation suddenly stops?

Dr.
Lin, I underwent a myomectomy and uterine artery embolization at Taipei Medical University in mid-December 2015.
My menstrual cycle changed from 25 days before the surgery to 29 days after.
1) Is this normal? 2) The first day of my menstrual period post-surgery is characterized by a small amount of dark brown discharge, with red flow appearing on the second or third day, which is different from my previous cycles when the fibroids had not grown large enough to require surgery.
Is this normal? 3) This month, my period has suddenly not arrived.
In mid-April, I experienced two brief episodes of abdominal discomfort associated with my menstrual cycle, which felt like bloating and pain that quickly subsided, and I also developed menstrual-related acne, leading me to believe my period would arrive early.
However, it has now been over eight days past the expected date, and I have no signs of my period.
I have never experienced this before, and I am unsure if it is related to the surgery.
Could you please clarify? Additionally, this month I have had increased discharge and used antibiotic suppositories.
I have also been under some stress due to certification exams and consumed cold beverages only 1-2 times.
Could these factors have caused my missed period? In the past, I have experienced similar situations but never missed a period entirely, which makes me quite anxious.
As I am married later in life and hope to conceive soon, I am very worried about this situation and feeling quite distressed.
I would greatly appreciate your insights, Dr.
Lin! Thank you!

Emily, 40~49 year old female. Ask Date: 2016/05/02

Dr. Lin Wenbin reply Obstetrics and Gynecology

Hello: Medications, stress, and many other factors can cause menstrual issues.
It is important for you to visit the clinic for a consultation with a physician, who can examine you and identify the underlying cause in order to provide appropriate management or treatment as soon as possible.
Thank you.

Reply Date: 2016/05/02

More Info

After undergoing a myomectomy and uterine artery embolization, it is not uncommon for women to experience changes in their menstrual cycles. Let's address your concerns one by one:
1. Menstrual Cycle Length Changes: It is normal for the menstrual cycle to change after surgery. The transition from a 25-day cycle to a 29-day cycle can be attributed to several factors, including hormonal adjustments following the removal of fibroids. Surgical procedures can temporarily disrupt the hormonal balance, leading to variations in cycle length. As your body heals, it may take some time for your menstrual cycle to stabilize.

2. Menstrual Flow Characteristics: The change in the color and amount of menstrual flow, particularly the presence of brown discharge initially, is also common. Brown blood typically indicates older blood that has taken longer to exit the uterus, which can happen when the flow is lighter. The fact that your flow has shifted to a more typical red color on subsequent days is a positive sign, indicating that your body is adjusting post-surgery.

3. Missed Period: It is concerning to experience a missed period, especially if this is unusual for you. Several factors can contribute to a missed period after surgery, including hormonal fluctuations, stress, and changes in lifestyle. The stress of preparing for an exam, as well as any recent changes in your diet or medication (like the use of antibiotic suppositories), can also impact your menstrual cycle. Stress can lead to hormonal imbalances that may delay ovulation or menstruation.

4. Physical Symptoms and Anxiety: The brief episodes of abdominal discomfort you experienced could be related to ovulation or other benign causes. However, since you mentioned that you have not had your period for over a week past the expected date, it is essential to monitor your symptoms closely. If you continue to miss your period or experience significant changes in your menstrual cycle, it would be wise to consult with your healthcare provider. They may recommend a pregnancy test to rule out pregnancy, as well as further evaluation to assess your hormonal levels and overall reproductive health.

In summary, while some changes in your menstrual cycle after myomectomy are expected, persistent irregularities, especially a missed period, warrant further investigation. It is crucial to maintain open communication with your healthcare provider, who can offer personalized advice based on your medical history and current situation. Additionally, managing stress through relaxation techniques or counseling may help regulate your menstrual cycle and improve your overall well-being. Remember, your health is paramount, and seeking guidance from a medical professional is always a prudent step when faced with uncertainties regarding your body.

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