Post-Surgery Menstrual Pain: What to Expect After Fibroid and Cyst Removal

Post-operative issues: Dysmenorrhea?

Hello, doctor: I underwent traditional laparoscopic surgery in early January this year to remove a 5 cm fibroid and two chocolate cysts.
My surgery was on January 2nd, and my first menstrual period after the surgery started on January 5th.
My menstrual cycles have always been regular, so it was expected that my period would come shortly after the surgery.
The first day of my first period post-surgery was very painful, feeling as if the incision might burst open (I had pre-existing dysmenorrhea before the surgery), but the flow was very light.
Now, on January 29th, which is the second day of my period, I am experiencing similar pain as if the incision might tear, and the menstrual flow is still very minimal, just like right after the surgery.
I would like to ask: 1.
Is it normal to experience this level of pain after surgery during menstruation? 2.
Is it normal to have a light menstrual flow? 3.
How long might it take for this menstrual pain to improve?

Miss Wang, 30~39 year old female. Ask Date: 2020/01/29

Dr. Cai Yonglong reply Obstetrics and Gynecology

Endometriosis and chocolate cysts require postoperative medication; this is essential for treating endometriosis.
Pain is expected to improve significantly after about 3 to 6 months.
Please visit the gynecology outpatient clinic.

Reply Date: 2020/01/29

More Info

After undergoing surgery for the removal of fibroids and chocolate cysts, it is not uncommon to experience changes in menstrual pain and flow. Your concerns about the pain and the amount of menstrual bleeding following your surgery are valid, and I will address each of your questions based on medical knowledge and common post-operative experiences.

1. Is it normal to experience pain during menstruation after surgery?
Yes, experiencing pain during your menstrual cycle after surgery can be normal, especially if you had pre-existing menstrual pain (dysmenorrhea) prior to the procedure. The surgical intervention can cause temporary changes in your body, including inflammation and healing of the tissues involved. The pain you describe, feeling as if the wound might "burst," could be related to the healing process of the surgical site. It's important to note that the uterus and surrounding tissues can be sensitive after surgery, and menstrual cramps may feel more intense as your body adjusts to the changes. However, if the pain is severe or worsening, it is essential to consult your healthcare provider to rule out any complications such as infection or improper healing.

2. Is it normal to have a reduced amount of menstrual bleeding?
Yes, it is also common to experience lighter menstrual bleeding after such surgeries. The removal of fibroids and cysts can alter the uterine lining and the hormonal balance in your body, which may lead to changes in your menstrual flow. Initially, you might notice that your periods are lighter than usual, and this can be a temporary effect as your body adjusts. Over time, your menstrual cycle may normalize, but if you continue to have significantly reduced bleeding or if you have concerns about your menstrual health, it is advisable to follow up with your doctor.

3. How long will it take for menstrual pain to improve?
The duration for improvement in menstrual pain can vary significantly from person to person. Generally, it may take a few menstrual cycles for your body to fully recover and for the pain to decrease. Many women find that their menstrual pain improves over the course of 2 to 3 cycles post-surgery. However, if you find that the pain persists or increases, or if you experience any unusual symptoms such as heavy bleeding, fever, or foul-smelling discharge, it is crucial to seek medical attention. Your doctor may want to perform an examination or imaging studies to ensure that everything is healing properly and to rule out any complications.

In summary, while some pain and changes in menstrual flow can be expected after surgery for fibroid and cyst removal, it is essential to monitor your symptoms closely. Keep a record of your menstrual cycles, including the intensity of pain and the amount of bleeding, and communicate any concerns to your healthcare provider. They can provide guidance tailored to your specific situation and help ensure that your recovery is progressing as expected. Remember that healing takes time, and your body is adjusting to significant changes.

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