Post-Myomectomy Symptoms: Why Am I Still Experiencing Heavy Periods? - Obstetrics and Gynecology

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After undergoing a myomectomy to remove a submucosal fibroid, it is concerning to hear that you are still experiencing heavy menstrual bleeding, blood clots, and prolonged periods three months post-surgery. This situation can be frustrating and may lead to further questions about your health and the effectiveness of the procedure.

First, it is essential to understand that while myomectomy is a common surgical procedure to remove fibroids, it does not always guarantee an immediate resolution of symptoms. In some cases, the underlying causes of heavy menstrual bleeding may not solely be due to the presence of fibroids. Other factors could contribute to your ongoing symptoms, including hormonal imbalances, the presence of additional fibroids that may not have been detected, or other uterine abnormalities.

The fact that your doctor performed a transvaginal ultrasound and found no abnormalities is a positive sign, but it does not entirely rule out the possibility of residual fibroid tissue or other conditions such as adenomyosis, which can also cause heavy menstrual bleeding. Adenomyosis occurs when the endometrial tissue grows into the muscular wall of the uterus, leading to similar symptoms as those caused by fibroids.

Hormonal factors play a significant role in menstrual cycles, and it is possible that your body is still adjusting post-surgery. The menstrual cycle is regulated by a complex interplay of hormones, and any disruption can lead to changes in bleeding patterns. If your doctor has suggested waiting for another cycle to see if your symptoms improve, it may be because they want to allow your body time to heal and regulate itself.

If your symptoms persist after the next menstrual cycle, it may be beneficial to discuss further options with your healthcare provider. One option mentioned is the use of a hormonal IUD (intrauterine device), such as the Mirena, which can help reduce menstrual bleeding by releasing progestin. This method can be effective for many women experiencing heavy periods, especially those with a history of fibroids.

Additionally, it is crucial to consider other potential causes of heavy menstrual bleeding, such as:
1. Endometrial Hyperplasia: A condition where the lining of the uterus becomes too thick, often due to excess estrogen without enough progesterone.

2. Coagulation Disorders: Conditions that affect blood clotting can lead to heavier menstrual bleeding.

3. Pelvic Inflammatory Disease (PID): An infection of the reproductive organs that can cause abnormal bleeding.

4. Thyroid Disorders: Both hyperthyroidism and hypothyroidism can affect menstrual cycles.

In conclusion, while it is understandable to be concerned about ongoing heavy periods after myomectomy, it is essential to communicate openly with your healthcare provider about your symptoms. If necessary, further evaluations such as a hysteroscopy or additional imaging studies may be warranted to rule out any remaining issues. It is vital to ensure that you receive comprehensive care and that your concerns are addressed adequately. Your health and well-being are paramount, and finding the right solution may take time and further investigation.