Hysteroscopy, Intercourse Pain, and Health Supplements

Q: Hysteroscopy, Intercourse Pain, and Health Supplements

Medical History： Four years ago, I underwent laparoscopic surgery to remove a chocolate cyst measuring approximately 3-5 cm. <br>Six months ago, I experienced irregular bleeding without a determined cause, along with long-standing dyspareunia that has become increasingly unbearab

Hysteroscopic surgery / Dyspareunia / Health supplements

Hello, thank you for taking the time to answer my questions despite your busy schedule.
Medical history: Four years ago, I underwent laparoscopic surgery to remove a chocolate cyst approximately 3-5 cm in size.
Six months ago, I experienced irregular bleeding with no identifiable cause, along with long-standing dyspareunia that has become increasingly unbearable.
Despite various recommendations from doctors, the pain has been so severe that I feel like kicking my partner out of bed.
After six months of irregular bleeding, I finally went to a medical center, where an ultrasound detected a suspected uterine fibroid about 2 cm in size.
The doctor scheduled a hysteroscopic endometrial curettage, which I completed three weeks ago, but it turned out to be a polyp rather than a fibroid.

(1) After the hysteroscopic surgery, how long should I wait before squatting, sitting for long periods, lifting heavy objects, and engaging in sexual intercourse? When can I start trying to conceive? (Each healthcare provider has given me different advice.) What are the consequences of not following these recommendations?
(2) The dyspareunia has been a significant source of distress for me, and I feel overwhelmed.
However, doctors have stated that my anatomy appears normal and there is no inflammation, except for one female doctor who mentioned congenital vestibulitis and recommended using lubricant.
I have tried an entire bottle of lubricant, but the pain persists.
Is there really no other solution? Would surgical intervention be an option?
(3) Following the hysteroscopic surgery and considering my previous gynecological history, a friend gave me Amway Nutrilite Protein Powder to help restore my body.
Is it safe to consume? I am genuinely concerned about the possibility of recurrence.
By the way, a doctor mentioned that this abnormal bleeding could indicate that I may be entering menopause.
Is this a possibility?
Thank you again for taking the time to respond.
Wishing you peace and well-being.

Yun Le, 30~39 year old female. Ask Date: 2019/09/20

Dr. Huang Jianzhong reply Obstetrics and Gynecology

Medical History: Four years ago, I underwent laparoscopic surgery to remove a chocolate cyst measuring approximately 3-5 cm.
Six months ago, I experienced irregular bleeding without a determined cause, along with long-standing dyspareunia that has become increasingly unbearable.
Despite various recommendations from doctors, I still experience pain severe enough to want to kick my partner out of bed.
After six months of continuous irregular bleeding, I finally went to a medical center where an ultrasound detected a suspected uterine fibroid of about 2 cm.
The doctor scheduled a hysteroscopic endometrial curettage, which I completed three weeks ago, but it turned out to be a polyp rather than a fibroid.

(1) After hysteroscopic surgery, how long should I wait before squatting, sitting for long periods, lifting heavy objects, and engaging in sexual intercourse? When can I start trying to conceive? (Every healthcare provider has given me different advice.) What are the consequences of not following these recommendations?
(2) Dyspareunia has been a significant concern for me, causing a lot of distress.
However, doctors have said that everything appears normal and there is no inflammation, except for one female doctor who mentioned congenital vestibulitis and recommended lubricants.
I have tried an entire bottle of lubricant, but the pain persists.
Are there really no other options? Would surgery be a solution?
(3) Following the hysteroscopic surgery and my previous gynecological history, a friend gave me Amway Nutrilite Protein Powder to help restore my body.
Is it safe to consume? I am genuinely worried about a recurrence.
By the way, a doctor mentioned that this abnormal bleeding might indicate that I am entering menopause.
Is that a possibility?
Answer: Blood tests.

Reply Date: 2019/09/20

More Info

Thank you for your detailed inquiry regarding your health concerns, particularly in relation to your history of endometriosis, recent surgical procedures, and ongoing issues with intercourse pain and irregular bleeding. I will address your questions systematically, providing insights based on medical knowledge and practices.

1. Post-Hysteroscopy Recovery and Activity Restrictions
After a hysteroscopy, the recovery period can vary depending on the individual and the specifics of the procedure performed. Generally, it is advisable to avoid strenuous activities, including heavy lifting and vigorous exercise, for at least 1-2 weeks post-procedure. This allows your body to heal properly and minimizes the risk of complications such as bleeding or infection.

Regarding sexual intercourse, it is typically recommended to wait 2-4 weeks after the procedure before resuming sexual activity. This timeframe allows the uterine lining to heal and reduces the risk of discomfort or complications. If you do not adhere to these recommendations, potential consequences may include increased pain, prolonged bleeding, or even the risk of infection.

If you are considering conception (preparing for pregnancy), it is best to consult with your healthcare provider. They can give personalized advice based on your recovery progress and overall health.

2. Intercourse Pain and Potential Solutions
Experiencing pain during intercourse, known as dyspareunia, can be distressing and may stem from various causes, including anatomical issues, hormonal changes, or psychological factors. Since your examinations have shown no structural abnormalities, it may be beneficial to explore the following options:
- Lubrication: While you mentioned trying lubricants without relief, it is essential to find a product that works for you. Water-based lubricants are often recommended, but silicone-based options may provide longer-lasting moisture.

- Pelvic Floor Therapy: A physical therapist specializing in pelvic floor dysfunction can help address muscle tension or spasms that may contribute to pain during intercourse.

- Counseling: If psychological factors are at play, speaking with a therapist who specializes in sexual health may provide strategies to alleviate anxiety and improve your experience.

- Medical Interventions: In some cases, procedures such as the release of pelvic adhesions or other surgical interventions may be necessary if anatomical issues are identified later on.

3. Health Supplements Post-Surgery
Regarding the use of health supplements like Amway Nutrilite Protein Powder after your hysteroscopy, it is generally safe to consume protein supplements unless specified otherwise by your healthcare provider. Protein can aid in recovery by supporting tissue repair and overall health. However, ensure that any supplement you take does not interfere with any medications you may be prescribed or exacerbate any existing conditions.

4. Irregular Bleeding and Menopause Considerations
Irregular bleeding can be concerning, especially after a history of endometriosis and recent surgery. While it is possible that you may be experiencing perimenopausal symptoms, especially if you are in your late 30s or early 40s, it is crucial to discuss this with your healthcare provider. They may recommend hormonal evaluations or other diagnostic tests to determine the underlying cause of your symptoms.

Conclusion
In summary, your situation involves multiple factors that require careful consideration and a tailored approach. It is essential to maintain open communication with your healthcare team, follow their recommendations regarding recovery, and explore various options for managing intercourse pain. If you have further concerns about your symptoms or treatment options, do not hesitate to seek a second opinion or additional consultations with specialists in gynecology or sexual health. Your health and comfort are paramount, and there are often multiple avenues to explore for relief and recovery.

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