Post-Polypectomy Bleeding: Your Menstrual Cycle Changes

Menstrual Period After Uterine Polyp Removal

Hello Dr.
Tsao, I have been experiencing prolonged bleeding for almost a month due to uterine polyps.
I underwent a hysteroscopic polypectomy on December 22, and the report indicated benign polyps.
However, I have continued to have intermittent bleeding since the surgery.
My bleeding situation is as follows: During the first week post-surgery, the bleeding was heavy, and on December 25, I experienced a significant hemorrhage and was urgently taken to the hospital.
Upon examination, my endometrium was normal (approximately 0.7 cm), but due to low hemoglobin levels, I received a blood transfusion and three doses of hemostatic injections.
After that, the bleeding decreased to a level similar to the 4th or 5th day of a menstrual cycle, and I was prescribed the hemostatic medication tranexamic acid.
In the second week post-surgery, while continuing the tranexamic acid, the report confirmed benign polyps.
The bleeding was lighter, with only a few instances of pink discharge when wiping throughout the day, resembling the end of a menstrual period, and sometimes there was no blood when wiping.
However, this situation persisted daily, with intermittent bleeding that did not completely stop.
In the third week post-surgery, starting January 7, the bleeding increased again.
From January 9 to January 12, the bleeding resembled the 3rd day of a menstrual cycle, with blood clots being expelled.
Despite taking tranexamic acid, the bleeding has not ceased, and I am uncertain whether this is abnormal bleeding or a true menstrual cycle.
I would like to ask Dr.
Tsao whether it is possible to have a menstrual period if the bleeding has not completely stopped after a hysteroscopic polypectomy, or if my situation might indicate abnormal bleeding.
Since the bleeding has not stopped, I am unsure if the increased bleeding is abnormal or if it is indeed my menstrual cycle.
Thank you for your response!

Mini, 30~39 year old female. Ask Date: 2022/01/13

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, abnormal bleeding or menstruation could both be possible.
It's advisable to observe over the next few days to see if the amount decreases.
If the bleeding remains heavy, it is recommended to consult a gynecologist.
Wishing you good health.

Reply Date: 2022/01/13

More Info

Post-polypectomy bleeding can be a concerning issue, especially when it extends beyond the expected recovery period. In your case, it seems that you have experienced prolonged bleeding after undergoing a hysteroscopic polypectomy for a benign uterine polyp. Let's break down your situation and address your questions regarding menstrual cycle changes and the nature of your bleeding.

Firstly, it is important to understand that after a polypectomy, some degree of bleeding is normal as the uterine lining heals. However, the duration and amount of bleeding can vary significantly from person to person. In your case, the bleeding has persisted for almost a month, which is longer than typical. The initial heavy bleeding you experienced post-surgery, requiring a blood transfusion, indicates that your body was responding to the surgical intervention. The fact that you were treated with hemostatic agents like tranexamic acid suggests that your healthcare provider is actively managing your bleeding.

Regarding your question about whether you can expect your menstrual cycle to resume normally while still experiencing bleeding: it is possible that the ongoing bleeding you are experiencing could be a continuation of the post-operative bleeding rather than a new menstrual cycle. The menstrual cycle is regulated by hormonal changes, and if your body is still in the process of healing, it may not have returned to its normal hormonal rhythm.
Typically, after a polypectomy, the menstrual cycle may be disrupted for a short period. Some women may experience irregular bleeding or spotting as their body adjusts. However, if the bleeding continues to be heavy or if you are passing clots, it may indicate that there is an underlying issue that needs to be addressed. It is essential to differentiate between normal post-operative bleeding and abnormal uterine bleeding, which could be due to retained tissue, infection, or other complications.

In your case, since you have noted an increase in bleeding and the presence of blood clots, it is crucial to follow up with your healthcare provider. They may recommend further evaluation, such as a pelvic ultrasound or additional imaging, to ensure that there are no complications such as retained polyp tissue or other abnormalities in the uterine lining.
Additionally, it is important to monitor for any signs of infection, such as fever, foul-smelling discharge, or worsening pain, as these could indicate a need for immediate medical attention.
In summary, while some bleeding after a polypectomy is expected, prolonged or increasing bleeding warrants further investigation. It is advisable to maintain open communication with your healthcare provider, who can provide personalized guidance based on your specific situation. They may adjust your treatment plan, including the use of medications or further diagnostic procedures, to ensure your recovery is on track and to address any potential complications.
In conclusion, while it is possible for your menstrual cycle to resume amidst ongoing bleeding, the nature of your bleeding should be closely monitored and evaluated by your healthcare provider to rule out any complications and ensure your overall health and well-being.

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