Post-Laparoscopy: Early Menstruation After Missing Progesterone Doses

Laparoscopic surgery to remove a chocolate cyst, missed taking progesterone for a week postoperatively, and menstruation occurred early?

Hello Dr.
Tsao,
In order to proceed with the in vitro fertilization process, I underwent laparoscopic surgery on November 7 to remove a chocolate cyst and uterine fibroids.
I have been taking progesterone during my hospitalization and the period after discharge.
However, I did not take progesterone on November 16 and 17, and although I took it on November 18, it seems that my menstrual period has arrived earlier than expected (the bleeding does not resemble post-operative bleeding).
Should I continue taking progesterone? Thank you.

maggie, 30~39 year old female. Ask Date: 2016/11/19

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, if your menstruation has arrived early, you should not continue taking progesterone.
Wishing you good health.

Reply Date: 2016/11/19

More Info

After undergoing laparoscopic surgery for the removal of endometriomas and uterine fibroids, it is understandable to have concerns regarding your menstrual cycle, especially in the context of fertility treatments. The situation you described involves a missed dose of progesterone (黄体素) on November 16 and 17, followed by an early onset of menstruation on November 18, despite taking the medication again on that day.
In general, progesterone is prescribed to help regulate the menstrual cycle, particularly in women undergoing fertility treatments or those with conditions like endometriosis. It plays a crucial role in preparing the uterine lining for potential implantation of an embryo. Missing doses of progesterone can lead to fluctuations in hormone levels, which may cause the menstrual cycle to be disrupted, resulting in early menstruation.

Given that you have already experienced what appears to be an early menstrual period, it is likely that continuing progesterone at this point may not be necessary. The primary function of progesterone in this context is to maintain the uterine lining and prevent menstruation; if menstruation has already begun, the need for additional progesterone diminishes. However, it is essential to consult your healthcare provider for personalized advice, as they can assess your specific situation and provide guidance based on your overall health and fertility goals.

In terms of recovery from your laparoscopic surgery, it is common to experience some irregularities in your menstrual cycle following such procedures. The body undergoes significant changes during surgery, and hormonal levels may take time to stabilize. Additionally, the presence of endometriosis and the surgical removal of lesions can further complicate the hormonal balance, leading to variations in menstrual timing and flow.

If you are concerned about your menstrual cycle or any other symptoms you are experiencing, such as pain or unusual bleeding, it is crucial to maintain open communication with your healthcare provider. They can monitor your recovery and make necessary adjustments to your treatment plan, including hormone therapy, if needed.

In summary, while it seems that you may not need to continue progesterone given the onset of menstruation, it is vital to discuss this with your doctor. They can provide tailored advice based on your medical history, the specifics of your surgery, and your fertility treatment plan. Remember that recovery from surgery can take time, and your body may need a few cycles to return to a more regular pattern. Regular follow-ups with your healthcare provider will help ensure that you are on the right track toward your fertility goals.

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