Post-Operative Concerns: Abnormal Menstrual Changes After Uterine Surgery

Postoperative care after uterine polypectomy?

Hello Doctor, I underwent surgery on February 26 to remove a uterine fibroid (4.9 cm) and a uterine polyp through laparotomy.
The surgery was performed towards the end of my menstrual period, and I was discharged from the hospital after three days.
However, in mid-March, I experienced three days of light brown discharge, which I thought was the onset of my period, but it stopped after three days.
Now, on March 20, my period officially started, but for the first three days, it was still a deep brown color with blood clots.
It wasn't until the fourth day that I began to see bright red blood.
The flow has been consistent, neither too much nor too little, and now, ten days later, my period shows no signs of tapering off.
Compared to before, my menstrual flow sometimes appears slightly viscous.
I am unsure if this is normal or if this is common in the first month after surgery.
During my follow-up appointment in the first week post-surgery, the doctor said everything was normal and my recovery was good, and I was not prescribed any medication.
Lastly, I have heard that uterine fibroids typically occur in women who have given birth, but I have not had children yet.
Is this normal? Thank you, Doctor.

Yun, 20~29 year old female. Ask Date: 2019/03/30

Dr. Huang Jianzhong reply Obstetrics and Gynecology

On February 26, I underwent laparoscopic surgery to remove a uterine fibroid (4.9 cm) and a uterine polyp.
The surgery was performed when my menstrual period was almost over, and I was discharged from the hospital after three days.
However, in mid-March, I suddenly experienced three days of brownish discharge, which was not much.
I thought my period was about to start, but it stopped after three days.
Now, on March 20, my period officially started, but for the first three days, it was still a dark brown color and included blood clots.
It wasn't until the fourth day that I began to see bright red blood.
The amount of bleeding has been consistent, and now, ten days later, there are still no signs of it decreasing.
Compared to before, my menstrual flow sometimes appears slightly viscous.
I'm unsure if this is normal or if this is common in the first month after surgery.

Answer: It is not typical for everyone to experience this in the first month after surgery, but it can be observed.
During the follow-up appointment in the first week after surgery, the doctor indicated that everything was normal and recovery was going well, and no medication was prescribed.
Lastly, I want to ask, many say that uterine fibroids occur in women who have given birth, but I have not had children yet.
Is this normal?
Answer: Yes, it is normal.

Reply Date: 2019/03/30

More Info

After undergoing surgery for uterine fibroids and polyps, it is not uncommon to experience changes in your menstrual cycle. The surgical procedure itself can lead to a variety of post-operative symptoms, including abnormal bleeding patterns, changes in menstrual flow, and the presence of blood clots.
Firstly, it is important to understand that the uterus undergoes significant changes during and after surgery. The removal of fibroids and polyps can alter the uterine lining, which may lead to irregular bleeding. The presence of brown discharge or coffee-colored blood, especially shortly after surgery, can be a result of old blood being expelled from the uterus. This is generally considered normal, particularly in the first few cycles following surgery.
Your experience of having a menstrual period that starts with dark brown blood and includes blood clots is not unusual. The first few menstrual cycles after surgery can be unpredictable, and it may take some time for your body to return to its normal rhythm. The fact that your menstrual flow has lasted for ten days and has included varying consistencies is something that many women experience post-operatively.
It is also worth noting that the consistency of menstrual blood can change due to hormonal fluctuations, which may be influenced by the surgery. The presence of clots and changes in color can be attributed to the body adjusting to the removal of fibroids and polyps, as well as the healing process of the uterine lining.
Regarding your concern about having fibroids despite not having given birth, it is a common misconception that only women who have had children develop fibroids. In reality, fibroids can occur in women of all reproductive backgrounds, and their development is influenced by a variety of factors, including genetics, hormone levels, and age.
If your menstrual irregularities persist beyond a few cycles, or if you experience severe pain, heavy bleeding, or any other concerning symptoms, it is crucial to follow up with your healthcare provider. They can perform an evaluation to ensure that there are no complications from the surgery and that your recovery is progressing as expected.

In summary, while it is normal to experience changes in your menstrual cycle after uterine surgery, it is essential to monitor your symptoms. If you have any concerns or if your symptoms worsen, do not hesitate to reach out to your healthcare provider for further evaluation and guidance. Your health and well-being are paramount, and open communication with your medical team is key to a smooth recovery.

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