Post-Surgery Bleeding After Ovarian Cyst Removal: Is It Normal?

Post-operative bleeding for six months after laparoscopic surgery while taking ethinyl estradiol?

Hello, Doctor.
I had laparoscopic surgery for an ovarian cyst last September, and the cyst was quite large, measuring 8 centimeters.
The surgeon mentioned that there was significant adhesion, although I usually do not experience much discomfort during my menstrual periods.
After the surgery, I received one injection of Lupron and have been diligently taking Esmya daily for about six months now.
On April 4th, I noticed vaginal bleeding.
After researching online, I found that this could be a side effect, so I continued taking the medication and waited for it to stop.
The bleeding lasted for about 8-9 days and was slightly lighter than my usual menstrual flow.
After it stopped, everything was fine until April 18th, but today I suddenly noticed bleeding again.
The amount is not very light, more like the flow I would have around the third day of my period.
I plan to follow up with my doctor next month to discuss this, but I am a bit concerned and wanted to ask if this situation is considered a normal side effect.
Should I consider switching medications in the future? Thank you, Doctor, for taking the time to respond!

Chen Xiaojie, 20~29 year old female. Ask Date: 2024/04/19

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, let's observe for now and discuss it with the doctor during your next appointment.
Wishing you good health.

Reply Date: 2024/04/19

More Info

Post-surgery bleeding, especially after procedures like ovarian cyst removal, can be a source of concern for many patients. In your case, experiencing vaginal bleeding after undergoing surgery for an ovarian cyst, particularly one as large as 8 cm, is not uncommon. Surgical interventions can lead to various physiological responses, including bleeding, due to the trauma inflicted on the tissues during the procedure.

Firstly, it’s important to understand that after any surgical procedure, the body goes through a healing process. This process can involve some degree of bleeding, which may manifest as spotting or a light flow. The fact that you experienced bleeding 8-9 days after your surgery and then again later could be attributed to several factors, including hormonal changes, the healing process, or even the medications you are taking.

You mentioned that you were prescribed Leuprolide (Lupin) and subsequently started taking another medication, likely for managing endometriosis or similar conditions. Leuprolide is a GnRH agonist that can cause changes in menstrual bleeding patterns, including breakthrough bleeding. This is a known side effect and can occur as your body adjusts to the medication. The bleeding you experienced could be a result of this hormonal fluctuation, especially if it was lighter than your usual menstrual flow.

The fact that you are experiencing bleeding similar to your menstrual cycle, particularly around the time you would expect your period, could also indicate that your body is still adjusting to the hormonal changes induced by the medications. It’s crucial to monitor the characteristics of the bleeding—such as its duration, volume, and any associated symptoms like pain or discomfort. If the bleeding becomes heavier or is accompanied by severe pain, it would be advisable to seek medical attention sooner rather than later.

In terms of your upcoming appointment, it’s a good idea to discuss these episodes of bleeding with your healthcare provider. They may want to evaluate whether the current medication regimen is appropriate for you or if adjustments are necessary. Sometimes, switching medications can help alleviate side effects like breakthrough bleeding.

Additionally, if you have concerns about the nature of the bleeding or if it persists, your doctor may recommend further investigations, such as an ultrasound or blood tests, to ensure that there are no underlying issues, such as retained tissue or other complications from the surgery.

In summary, while some post-surgery bleeding can be normal, especially after ovarian cyst removal, it’s essential to keep an open line of communication with your healthcare provider. They can provide personalized advice based on your specific situation and medical history. Keeping track of your symptoms and any changes will be beneficial for your next appointment. Remember, your health and peace of mind are paramount, so don’t hesitate to reach out to your doctor with any concerns you may have.

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