Post-Surgery Menstrual Changes: When to Seek Help

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I apologize, doctor, for continuing from the previous response.
I had surgery in January this year and received three doses of medication.
My menstruation returned in June, and it has been five months since then.
Is this considered normal? In July, I had a follow-up appointment, and the doctor advised me to return in a year.
In September, due to my situation, I had another follow-up, and the doctor told me to observe for now.
Two months later, I experienced the following: three days before my period, there was light spotting (the amount was less than one panty liner for the entire day).
I consulted with the doctor, who advised me to observe further.
After that, my period officially started, lasting about six days, with the last day being just a little spotting (again, less than one panty liner for the entire day).
In October and November, my period began with light spotting for one to one and a half days (still less than one panty liner for the entire day) before officially starting, lasting about five days, followed by another day and a half of light spotting (again, less than one panty liner for the entire day).
So, from the onset of red bleeding to no bleeding lasted about eight days.
Is this situation acceptable, or do I need to return for another check-up? Thank you!
Questioner: Morn / Female / 28, 2015/11/26
Doctor, I have endometriosis and underwent surgery this year to remove adenomyosis and cysts.
After six months of amenorrhea, my menstruation returned two months later.
Three days before my period, there was light spotting (the amount was less than one panty liner for the entire day).
I consulted with the doctor, who advised me to observe before my period officially started, lasting about six days, with the last day being just a little spotting (again, less than one panty liner for the entire day).
In October and November, my period began with light spotting for one to one and a half days (still less than one panty liner for the entire day) before officially starting, lasting about five days, followed by another day and a half of light spotting (again, less than one panty liner for the entire day).
So, from the onset of red bleeding to no bleeding lasted about eight days.
Is this situation acceptable, or do I need to return for another check-up?
Responder: Changhua Hospital / Obstetrics and Gynecology / Dr.
Lin Wen-bin, 2015/11/26
After such surgery, it is common to undergo medication treatment for six months.
After six months, menstruation may return, but it can take 3 to 4 months to gradually normalize.
I recommend that you return for a follow-up appointment to have your ovarian condition checked.

Men, 20~29 year old female. Ask Date: 2015/11/26

Dr. Lin Wenbin reply Obstetrics and Gynecology

Please return for a follow-up examination.

Reply Date: 2015/11/26

More Info

After undergoing surgery, especially for conditions like endometriosis or uterine fibroids, it's not uncommon for women to experience changes in their menstrual cycle. The situation you've described, where your menstrual flow has been irregular and characterized by light spotting followed by a few days of bleeding, can be concerning but may also be part of the normal healing process.

1. Post-Surgery Menstrual Changes: After surgeries involving the reproductive system, such as the removal of fibroids or endometriosis, hormonal levels can be disrupted. This disruption can lead to irregular menstrual cycles, including changes in flow, duration, and the presence of spotting. It is important to note that it can take several months for your body to readjust and for your menstrual cycle to normalize after such procedures. The fact that you are experiencing light spotting before your period officially starts is not unusual, especially in the first few months post-surgery.

2. When to Seek Help: While some irregularities can be expected, there are certain signs that should prompt you to seek further medical evaluation. If you experience any of the following, it is advisable to consult your healthcare provider:
- Significant changes in the volume of bleeding (e.g., soaking through a pad in an hour).

- Severe pain that is not manageable with over-the-counter pain relief.

- Prolonged periods of spotting or bleeding that last longer than a week.

- Any new symptoms such as fever, chills, or unusual discharge, which could indicate an infection.

3. Monitoring Your Symptoms: Since your doctor has advised you to observe your symptoms, it is essential to keep a detailed record of your menstrual cycle, including the duration, flow, and any accompanying symptoms. This information can be invaluable for your healthcare provider in assessing your condition during your next visit.

4. Follow-Up Care: Given that you have a history of endometriosis and have undergone significant surgical procedures, regular follow-up appointments are crucial. Your doctor may want to monitor your ovarian function and overall reproductive health, especially if you continue to experience irregularities in your menstrual cycle. If your symptoms persist or worsen, do not hesitate to reach out for a follow-up appointment sooner than planned.

5. Potential Treatments: Depending on your symptoms and the findings during your follow-up visits, your doctor may recommend additional treatments. This could include hormonal therapies to help regulate your menstrual cycle or further imaging studies to assess the status of your ovaries and uterus.

In conclusion, while some irregularities in your menstrual cycle post-surgery can be expected, it is essential to remain vigilant and proactive about your health. Keeping track of your symptoms and maintaining open communication with your healthcare provider will help ensure that any potential issues are addressed promptly. If you have any concerns or if your symptoms change, do not hesitate to seek medical advice. Your health and well-being should always be your top priority.

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