Endometrial Polyps: Post-Procedure Menstrual Changes and Concerns

Q: Endometrial Polyps: Post-Procedure Menstrual Changes and Concerns

Hello： Based on your situation, it is advisable to pay attention to the following issues： 1. <br>You need to understand whether your endometrial cells are at risk for malignant transformation, how long you will need medication treatment, and whether follow-up examinations are nec

Endometrial polyp

Hello, in mid-April, I noticed some abnormal bleeding and went to see a doctor.
After an ultrasound, it was found that I had a 1 cm endometrial polyp, so I underwent a dilation and curettage (D&C) on April 19.
During my follow-up appointment a week later, the doctor mentioned that there were some abnormal cells in the endometrium, but they were not malignant.
However, I need to take Provera for three months for treatment.
I have a couple of questions for the doctor:
1.
After the D&C, when should I consider my next menstrual period starting? Should I count from my last period on April 2, or from the day of the procedure on April 19? I'm not quite sure when to expect my next period.
2.
After the surgery on April 19, the doctor prescribed me Provera 10 mg for ten days, to take one pill in the morning and one in the evening starting from May 3.
Since this is my first time taking this medication, I experienced some physiological changes.
On May 5, I had lower back pain similar to the first day of my usual period, but there was no bleeding.
On May 8, I noticed some blood-tinged discharge, and on the morning of May 9, there was still blood-tinged discharge.
Around noon, I suddenly had bright red discharge that resembled the onset of menstruation, but it subsided shortly after to just a little bit of red discharge, which continued until the evening.
On May 10, I still had red discharge in the morning, and in the afternoon, it looked like my period was starting again, but similar to the previous day, it was just a little bit of red discharge.
When I went to the bathroom, I noticed a small blood clot.
Is this situation considered normal? The doctor originally instructed me to take the medication from May 3 to May 13, and that my period would come after stopping the medication.
However, I am unsure about my current situation, as it feels like my period is about to start, but it doesn't feel like a typical menstrual flow.
I apologize for the trouble, but I would appreciate your guidance.

Rita, 20~29 year old female. Ask Date: 2012/05/10

Dr. Dong Yuhong reply Obstetrics and Gynecology

Hello: Based on your situation, it is advisable to pay attention to the following issues: 1.
You need to understand whether your endometrial cells are at risk for malignant transformation, how long you will need medication treatment, and whether follow-up examinations are necessary.
2.
After the minor surgery, the timing of your menstrual period may differ from your initial expectations, so the physician will prescribe relevant medications to adjust the treatment based on your condition.
However, if you experience any discomfort from the medication or if your situation differs from the physician's expectations, it is recommended to return for an earlier consultation so that your attending physician can make necessary adjustments to your treatment.
Thank you!

Reply Date: 2012/05/10

More Info

Understanding endometrial polyps and the subsequent changes in menstrual patterns after procedures like hysteroscopic removal can be quite complex. Let's break down your questions and concerns regarding your recent experience with endometrial polyps and the treatment you are undergoing.

1. Menstrual Cycle Timing Post-Procedure: After a hysteroscopic removal of an endometrial polyp, the timing of your next menstrual period can vary. Typically, the menstrual cycle is counted from the first day of your last menstrual period (LMP), which in your case was April 2. However, the procedure on April 19 may also influence your cycle. Generally, after such a procedure, it may take some time for your body to adjust, and your next period could be delayed or altered. It is not uncommon for women to experience changes in their menstrual cycle following a surgical procedure. Therefore, while you can expect your next period to be around the time you would normally expect it based on your LMP, it may also be affected by the surgery and the medications you are taking.

2. Post-Operative Symptoms and Provera: The symptoms you are experiencing after starting Provera (medroxyprogesterone acetate) are not unusual. Provera is a synthetic form of progesterone, and it can cause various side effects, including changes in menstrual bleeding patterns. The initial phase of taking Provera may lead to spotting or breakthrough bleeding, which can resemble a menstrual period but is not a full menstrual cycle. The presence of blood-tinged discharge or spotting, as you described, can be a common response to the medication, especially in the first few days of treatment.
It is important to note that Provera is often prescribed to help regulate the menstrual cycle and reduce the risk of endometrial hyperplasia, especially after abnormal findings like those you experienced. The blood clots and the varying flow you are noticing could be due to the hormonal changes induced by the medication.
3. Normalcy of Your Symptoms: The symptoms you are experiencing, including the spotting and the presence of small blood clots, can be considered normal in the context of your recent surgery and the initiation of Provera. However, if the bleeding becomes heavy, or if you experience severe pain or other concerning symptoms, it is crucial to contact your healthcare provider for further evaluation.
In summary, after a hysteroscopic removal of an endometrial polyp, it is common for menstrual cycles to be irregular for a few months. The Provera you are taking may also contribute to changes in your bleeding patterns. It is essential to monitor your symptoms and maintain open communication with your healthcare provider to ensure that your treatment is effective and to address any concerns you may have. If you have any further questions or if your symptoms change, do not hesitate to reach out to your doctor for guidance. Your health and peace of mind are paramount, especially as you navigate through these changes.

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