Menstrual Changes After Laparoscopic Surgery and Medication

The future of the menstrual cycle after the use of Liu Pulin?

Hello, doctor.
I underwent laparoscopic surgery to remove a chocolate cyst at the end of February and received a dose of Leuprolide.
Due to my inability to return for regular injections, I received a long-acting (three-month) injection at the end of March.
As of now, I still have not gotten my menstrual period, and the side effects of Leuprolide are still present.
Is this normal? Thank you!

Xiao Mi, 30~39 year old female. Ask Date: 2015/08/18

Dr. Xu Junrui reply Obstetrics and Gynecology

The main effect of Liu Pulin medication is to induce a phenomenon of "pseudo-menopause" in the ovaries, thereby achieving ovarian rest and suppressing the effects of endometriosis.
While it is true that the long-acting formulation has an efficacy duration of three months, there can indeed be instances of delayed menstruation.
However, since you completed your surgery in February, I recommend that you return for a follow-up appointment for postoperative monitoring and a comprehensive consultation!

Reply Date: 2015/08/18

More Info

After undergoing laparoscopic surgery for the removal of a chocolate cyst and receiving hormonal treatment with Lupron (leuprolide), it is understandable to have concerns regarding menstrual changes and the side effects of the medication.
Firstly, it is important to recognize that hormonal treatments like Lupron are designed to suppress ovarian function and reduce estrogen levels in the body. This can lead to a temporary cessation of menstruation, which is a common and expected outcome. Many patients experience amenorrhea (the absence of menstruation) while on Lupron, especially after receiving long-acting formulations. This is because the medication effectively induces a state similar to menopause, which can halt the menstrual cycle.
The duration of amenorrhea can vary from person to person. In some cases, menstruation may not resume until several months after discontinuing the medication. It is also worth noting that the side effects of Lupron can include hot flashes, mood swings, and changes in libido, among others. These side effects can persist as long as the medication is active in your system, which can be several weeks to months, depending on the dosage and individual metabolism.

Regarding your specific situation, since you received a long-acting injection at the end of March, it is not unusual for your menstrual cycle to be delayed or absent for an extended period. If you have not experienced any significant discomfort or unusual symptoms (such as severe abdominal pain or heavy bleeding), it is generally considered normal. However, if you have concerns about the side effects or if you experience any new or worsening symptoms, it is advisable to consult your healthcare provider for further evaluation.

In terms of monitoring your recovery and menstrual health post-surgery, it is essential to maintain regular follow-ups with your healthcare provider. They can assess your hormonal levels and overall reproductive health, and if necessary, adjust your treatment plan. If menstruation does not resume after the expected duration following the cessation of Lupron, further investigation may be warranted to rule out other underlying conditions.

In summary, the absence of menstruation after laparoscopic surgery and Lupron treatment is typically normal and expected. However, it is crucial to stay in touch with your healthcare provider to ensure that your recovery is on track and to address any concerns you may have regarding your menstrual health and the side effects of your medication.

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