Post-Laparoscopic Surgery: Your Menstrual Changes and Concerns

Postoperative monitoring after laparoscopic surgery?

I would like to ask Dr.
Huang: I underwent laparoscopic surgery to remove an endometrioma and a submucosal uterine fibroid on October 24.
I got my first menstrual period on November 13, and the flow was heavier with bright red blood on days 2 to 4.
Now, on day 9, I am still experiencing a small amount of bright red blood.
Is this normal? I have been taking Gestrinone for two weeks.
Should I return for a follow-up appointment?

Xiao Mei, 30~39 year old female. Ask Date: 2017/11/21

Dr. Huang Jianzhong reply Obstetrics and Gynecology

On October 24, I underwent laparoscopic surgery to remove a chocolate cyst and a submucosal uterine fibroid.
Currently, on November 13, I experienced my first menstrual cycle.
The flow was heavier with bright red blood on days 2 to 4, and now, on day 9, I am still experiencing a small amount of bright red blood.
Is this normal? I have been taking Gestrinone for two weeks.
Should I return for a follow-up appointment? Answer: This is normal, and there is no need for a follow-up appointment at this time.

Reply Date: 2017/11/21

More Info

After undergoing laparoscopic surgery for the removal of a chocolate cyst and a submucosal uterine fibroid, it is not uncommon to experience changes in your menstrual cycle. The fact that you had your first menstrual period on November 13, just a few weeks post-surgery, indicates that your body is beginning to return to its normal hormonal rhythm. However, the characteristics of your menstrual flow, particularly the prolonged duration and the presence of bright red blood, warrant a closer look.

1. Menstrual Changes Post-Surgery: It is typical for menstrual cycles to be irregular or different in flow and duration following any surgical procedure, especially one involving the reproductive organs. The presence of bright red blood can indicate fresh bleeding, which may be a result of the surgical intervention. The first few cycles after surgery can be particularly variable as your body adjusts.
2. Duration of Menstrual Flow: A menstrual period lasting longer than a week can be concerning, especially if it is accompanied by heavy bleeding. While some women may experience longer periods after surgery, it is essential to monitor the situation. If you are soaking through pads or tampons every hour, or if you experience severe pain, it is advisable to seek medical attention.

3. Medication Impact: You mentioned taking Gestrinone, which is a synthetic steroid that can affect your menstrual cycle. It is often prescribed to manage endometriosis and can lead to changes in bleeding patterns. If you have been on this medication for two weeks, it may also be influencing your menstrual flow. It’s important to discuss any side effects or concerns regarding this medication with your healthcare provider.

4. When to Return for Follow-Up: Given that you are experiencing prolonged bleeding, it would be prudent to schedule a follow-up appointment with your doctor. They can assess whether your bleeding is within normal limits or if further investigation is needed. This is particularly important if you have any other symptoms such as dizziness, fatigue, or significant pain.

5. Normal Recovery: Post-operative recovery can vary widely among individuals. Some women may experience a return to normalcy quickly, while others may take longer. Factors such as the extent of the surgery, your overall health, and any underlying conditions can all play a role in your recovery.

In summary, while some changes in your menstrual cycle after laparoscopic surgery are expected, the prolonged duration and characteristics of your bleeding should be evaluated by your healthcare provider. It is always better to err on the side of caution, especially when it comes to post-surgical recovery and menstrual health. Make sure to keep track of your symptoms and communicate openly with your doctor about any concerns you may have.

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