Post-Laparoscopy: Your First Menstrual Cycle Changes

First menstruation after laparoscopic removal of endometriosis and uterine fibroids?

Hello, doctor.
I underwent a second laparoscopic surgery for endometriosis and uterine fibroids at the end of June.
My menstrual period has been delayed by two weeks compared to normal, and the flow has been light and lasted for three weeks up to now.
I had a follow-up ultrasound, and there were no abnormalities in the ovarian area.
I am currently taking hormone medication and would like to know if this situation with my first menstrual period after surgery is normal.
Can hormone medication affect menstruation? What should I pay attention to in my daily life? Thank you.

Niming, 30~39 year old female. Ask Date: 2020/08/13

Dr. Huang Yuande reply Obstetrics and Gynecology

1.
It is common for the menstrual cycle to be easily disrupted after ovarian and uterine surgeries.
As long as the bleeding is not excessive, it is generally sufficient to monitor the situation.
2.
Since you did not specify the reason for using "hormones," it is difficult to assess.
Typically, medications that suppress female hormones are used for endometriosis, which can lead to reduced menstrual flow or infertility.

Reply Date: 2020/08/13

More Info

After undergoing laparoscopic surgery for endometriosis and uterine fibroids, it is not uncommon to experience changes in your menstrual cycle. Your report of a delayed period by two weeks, along with lighter flow and prolonged duration, can be attributed to several factors related to the surgery and hormonal treatment.

Firstly, surgical procedures on the reproductive organs can temporarily disrupt the normal hormonal balance in your body. The menstrual cycle is regulated by a complex interplay of hormones, primarily estrogen and progesterone. After surgery, your body may take some time to readjust, which can lead to irregularities in your cycle. It is not unusual for women to experience changes such as delayed menstruation, lighter periods, or even missed cycles following laparoscopic surgery.

Regarding the hormonal medication you are currently taking, it can indeed influence your menstrual cycle. Hormonal treatments are often prescribed to manage symptoms of endometriosis and to help regulate menstrual cycles. Depending on the type of hormone therapy, it can lead to lighter periods or even amenorrhea (absence of menstruation). If you are taking hormonal contraceptives or other forms of hormone therapy, these can significantly alter your menstrual flow and cycle regularity.

It is essential to monitor your symptoms and maintain communication with your healthcare provider. If your menstrual irregularities persist or if you experience any concerning symptoms such as severe pain, heavy bleeding, or signs of infection (fever, chills, unusual discharge), you should seek medical advice promptly.
In terms of daily care, here are some recommendations:
1. Track Your Cycle: Keep a record of your menstrual cycle, noting any changes in flow, duration, and associated symptoms. This information can be helpful for your healthcare provider.

2. Healthy Lifestyle: Maintain a balanced diet and regular exercise, as these can positively influence hormonal balance and overall well-being.

3. Manage Stress: Stress can also impact your menstrual cycle. Consider incorporating stress-reducing activities such as yoga, meditation, or deep-breathing exercises into your routine.

4. Follow-Up Appointments: Attend all scheduled follow-up appointments with your healthcare provider to monitor your recovery and discuss any ongoing concerns regarding your menstrual cycle or hormonal treatment.

In conclusion, while the changes you are experiencing in your menstrual cycle after laparoscopic surgery and hormonal treatment can be concerning, they are often within the realm of normal post-operative recovery. However, continuous monitoring and communication with your healthcare provider are crucial to ensure that your recovery progresses smoothly and to address any potential complications.

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