Post-Surgery Concerns: Irregular Periods and Ovarian Cysts Explained

From the surgery for the chocolate cyst until now?

Hello doctor, last October I had surgery for a chocolate cyst, and now it has been five months without my period.
I returned for a follow-up on March 1st, and the doctor prescribed me Diane contraceptive pills, which I took for nine days.
I gained weight and felt bloated, so I gave up on the medication.
Will my period return? Also, the ultrasound showed fluid accumulation; why is there fluid in my uterus? What should I do now? Thank you.

Jun, 30~39 year old female. Ask Date: 2021/03/11

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, menstruation typically occurs within a week after stopping medication.
After your period returns, please visit the obstetrics and gynecology department for a follow-up examination.
Wishing you good health.

Reply Date: 2021/03/11

More Info

After undergoing surgery for a chocolate cyst, it is not uncommon to experience irregularities in your menstrual cycle. The hormonal changes that occur post-surgery, combined with the effects of medications such as birth control pills, can significantly impact your periods. In your case, it seems that you have not had a menstrual period for five months, which can be concerning.
Firstly, it’s important to understand that after surgery for ovarian cysts, especially chocolate cysts (which are a type of endometrioma), your body may take some time to return to its normal hormonal rhythm. The absence of menstruation for several months could be due to several factors, including hormonal imbalances, the effects of surgery, or the impact of any medications you have taken, such as the birth control pills. Birth control pills can sometimes cause side effects like weight gain and bloating, which you have experienced. These side effects can lead to discontinuation of the medication, which may further affect your menstrual cycle.

Regarding the accumulation of fluid in the uterus, known as hydrometra, this can occur for various reasons. It might be related to hormonal changes, scarring from surgery, or even an obstruction in the reproductive tract. It is essential to follow up with your healthcare provider regarding this finding, as they may recommend further evaluation, such as additional imaging or a hysteroscopy, to determine the cause and appropriate treatment.

Given your situation, here are some steps you can take:
1. Follow-Up Appointment: Schedule a follow-up appointment with your healthcare provider to discuss your lack of menstruation and the ultrasound findings. They may want to perform additional tests to assess your hormonal levels or the status of your uterus.

2. Monitor Symptoms: Keep track of any other symptoms you may be experiencing, such as pelvic pain, unusual discharge, or changes in weight. This information can be helpful for your doctor in determining the next steps.

3. Consider Hormonal Therapy: If your doctor determines that hormonal imbalances are contributing to your irregular periods, they may suggest alternative hormonal therapies or adjustments to your current treatment plan.

4. Lifestyle Factors: Consider lifestyle factors that can influence your menstrual cycle, such as stress, diet, and exercise. Maintaining a healthy lifestyle can sometimes help regulate your menstrual cycle.

5. Be Patient: Understand that recovery from surgery can take time, and it may take a few months for your menstrual cycle to normalize. However, it is crucial to stay in communication with your healthcare provider throughout this process.

In summary, while it is not unusual to experience irregular periods after surgery for a chocolate cyst, it is essential to address your concerns with your healthcare provider. They can provide you with the best guidance based on your specific situation, including the management of any fluid accumulation in the uterus and the potential need for further treatment.

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