Menstrual Changes After Uterine Polyp Surgery

Postoperative Menstruation After Uterine Polypectomy

Hello, Doctor: My last menstrual period started on December 15.
I underwent a hysteroscopic cold knife endometrial polypectomy on December 28.
Prior to the procedure, I took two doses of a uterine dilator and approximately six small polyps, each about 1.5 cm, were removed (which were sent for pathology and confirmed to be benign).
After the surgery, I experienced light pink spotting 2-3 times daily.
However, today, January 6, the bleeding has changed to a color resembling the first day of my menstrual period, no longer light pink, and I noticed what appears to be endometrial shedding in the toilet.
My usual menstrual cycle is about 25-26 days.
Is this an early onset of menstruation, or could it indicate that the endometrial healing is not yet complete? Typically, after a uterine polyp surgery, does menstruation usually return about a month later, or does it follow the regular cycle? (I have done some research, but the information varies.) Thank you.

Nancy, 40~49 year old female. Ask Date: 2024/01/06

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, let's observe for now.
If there are still many issues, I recommend returning to your original obstetrician-gynecologist for an examination.
Wishing you good health.

Reply Date: 2024/01/06

More Info

After undergoing uterine polyp surgery, it is common for patients to experience changes in their menstrual cycle. The surgery you had on December 28 involved the removal of several small polyps, which can indeed affect the uterine lining and, consequently, your menstrual flow and timing.

Typically, after such a procedure, the menstrual cycle may be disrupted for a short period. The presence of light pink spotting for several days post-surgery is not unusual, as this can be a sign of the healing process. The fact that you are now experiencing a flow that resembles the first day of your menstrual period indicates that your body may be responding to the surgical intervention.
Regarding your question about whether this is an early period or a sign that the endometrial lining is still healing, it is essential to consider a few factors. First, the menstrual cycle can be influenced by various factors, including hormonal changes, stress, and physical trauma, such as surgery. Your usual cycle of 25-26 days may be temporarily altered due to the surgery, and it is possible that your body is adjusting to the changes in the uterine lining.

In general, after a uterine polyp removal, menstruation can return to normal within a month, but it is not uncommon for it to be slightly earlier or later than your typical cycle. The healing of the endometrial lining can also lead to variations in menstrual flow, including the presence of tissue that may appear as "endometrial shedding." This is a normal part of the healing process, especially after the removal of polyps.

It is also important to note that while some women may resume their regular menstrual cycle shortly after surgery, others may experience irregularities for a few cycles. If you find that your bleeding is excessively heavy, accompanied by severe pain, or lasts longer than a week, it would be prudent to consult your healthcare provider. They may want to perform an ultrasound or other evaluations to ensure that there are no complications, such as retained tissue or infection.

In summary, the changes you are experiencing in your menstrual cycle after uterine polyp surgery are likely a normal response to the procedure. It is essential to monitor your symptoms and maintain open communication with your healthcare provider to ensure a smooth recovery and address any concerns you may have. If your menstrual cycle does not stabilize within a few months or if you have any unusual symptoms, seeking medical advice is always a good practice.

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