Abnormal Menstrual Bleeding: Causes and Post-Surgery Concerns - Obstetrics and Gynecology

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Menstrual irregularities


Hello, Doctor.
My last normal menstruation was on June 4th (lasting 3 days).
My period started on July 8th and continued until July 15th, with a light flow, only about the size of a 50 NT dollar coin each day, which required only a panty liner.
On July 14th, I visited a gynecologist and had a transvaginal ultrasound, which revealed a uterine polyp.
A hysteroscopy and endometrial curettage were scheduled for July 17th, and the follow-up examination showed it was benign.
The doctor advised me to return for follow-up after my next menstruation.
(Actually, from February 10th to February 17th, I also experienced abnormal light bleeding, but the transvaginal ultrasound showed a shadow.
After taking ovulation medication, my menstruation in March was normal, and the shadow was gone.) However, on August 1st, I started bleeding on the first day, and the flow was similar to the first day of my period, but I am unsure if this is menstruation or abnormal bleeding, as my normal cycle is usually between 38 to 42 days, lasting 3 to 4 days.
I have no sexual experience but have used internal tampons and a menstrual cup.
I would like to ask the doctor: 1.
After surgery, does menstruation typically occur about a month later? Is it normal for me to have my period on August 1st after surgery on July 17th? If it is not normal, should I return for an immediate check-up, or should I observe for a few more days? 2.
Do uterine polyps grow suddenly, or are there factors that contribute to their development? Is there a chance of recurrence in the future? Thank you, Doctor, for taking the time to answer my questions.

Niming, 20~29 year old female. Ask Date: 2017/08/01

Dr. Huang Jianzhong reply Obstetrics and Gynecology


The last normal menstruation was on June 4 (lasting 3 days).
Menstruation started on July 8 and continued until July 15, with a light flow, only the size of a 50 NT dollar coin, requiring only a panty liner.
On July 14, I consulted a gynecologist and underwent a transvaginal ultrasound, which revealed a uterine polyp.
A hysteroscopy and endometrial curettage were scheduled for July 17, and the follow-up examination indicated it was benign.
The doctor advised to return for follow-up after the next menstruation.
(Actually, from February 10 to February 17, there was also abnormal light bleeding, but the transvaginal ultrasound showed a shadow.
After taking ovulation medication, the March menstruation was normal, and the shadow was gone.) However, on August 1, bleeding started on the first day, resembling the first day of menstruation, but I am unsure if this is menstruation or abnormal bleeding, as my normal cycle is between 38 to 42 days with bleeding lasting 3 to 4 days.
I have no sexual experience but have used internal tampons and a menstrual cup.
I would like to ask the doctor: 1.
After the surgery, does menstruation usually come about a month later? Is it normal for me to have bleeding on August 1 after the surgery on July 17? If it is not normal, should I return for an immediate check-up, or should I observe for a few more days? 2.
Do uterine polyps grow suddenly, or are there factors that contribute to their appearance? Is there a chance of recurrence afterward? Answer: With no sexual experience, how is a hysteroscopy and endometrial curettage performed?

Reply Date: 2017/08/01

More Info


Understanding abnormal menstrual bleeding can be complex, especially after surgical interventions like a hysteroscopy and endometrial curettage. Your situation involves several factors, including your recent surgery for a uterine polyp, your menstrual history, and the nature of your bleeding. Let’s address your questions systematically.

1. Post-Surgery Menstrual Cycle: After a surgical procedure like the one you underwent on July 17, it is common for menstrual cycles to be irregular for a short period. The body may take some time to adjust following the removal of a polyp and the scraping of the endometrial lining. Typically, menstruation can resume anywhere from 4 to 8 weeks post-surgery, depending on individual healing and hormonal balance. Since your surgery was on July 17 and you experienced bleeding starting on August 1, this could be considered within the normal range, especially if the bleeding resembles your typical menstrual flow. However, if the bleeding is significantly heavier than usual, lasts longer than your typical cycle, or is accompanied by severe pain or other concerning symptoms, it would be prudent to consult your healthcare provider sooner rather than later.

2. Uterine Polyps: Uterine polyps can indeed develop suddenly, and their exact cause is not always clear. They are often associated with hormonal changes, particularly estrogen. Factors that may contribute to the development of polyps include obesity, hormone replacement therapy, and certain medications. While some women may experience polyps as a result of hormonal fluctuations, others may have them without any identifiable risk factors. As for recurrence, there is a possibility that polyps can return after removal. Regular follow-ups with your gynecologist are essential to monitor for any new growths, especially if you have a history of polyps.

In terms of your menstrual health, it’s important to keep track of your cycles and any changes in bleeding patterns. If you notice any significant deviations from your normal cycle, such as prolonged bleeding, increased pain, or any other unusual symptoms, do not hesitate to reach out to your healthcare provider. They may recommend further evaluation, such as ultrasound or additional imaging, to ensure that everything is healing properly and to rule out any complications.

Additionally, maintaining a healthy lifestyle, including a balanced diet and regular exercise, can support your overall reproductive health. Stress management techniques, such as yoga or meditation, may also be beneficial, as stress can impact hormonal balance and menstrual regularity.

In summary, while your recent bleeding could be a normal response to surgery, it’s crucial to remain vigilant. Keep a record of your symptoms and don’t hesitate to seek medical advice if you have concerns. Regular follow-ups with your gynecologist will help ensure that any potential issues are addressed promptly, contributing to your overall reproductive health and well-being.

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