OpenHealth Q&A

Heavy and Painful First Period After Laparoscopic Myomectomy: Is It Normal?

A 33-year-old woman shares her experience post-laparoscopic myomectomy. Prior to undergoing the procedure, she visited her gynecologist due to ongoing bleeding that lasted approximately 40 days, fluctuating in intensity. An ultrasound revealed the presence of a large mass in her uterus that was concerning. The surgery she underwent involved removing a myoma that measured around 6 to 7 centimeters, along with a curettage to eliminate any potential polyps and investigate for any other irregularities. During the operation, the medical team first performed a curettage and then proceeded with the laparoscopy, successfully excising the submucosal myoma. This required reconstructive work on the uterus at the site of the excision. While operating, they also discovered a second myoma, larger than the first, which was only noticed during the laparoscopy due to its unique location. Additionally, cysts on both fallopian tubes were popped, likely as they were non-functional. Her recovery thus far has been straightforward. The discomfort she experienced before the surgery has largely dissipated, and she found that her need for pain relief was minimal after the initial 1-2 days spent in the hospital. Following medical advice, she adhered to a regimen of rest and only began taking short walks with her brother and dog after two weeks. Fast forward about four weeks after the surgery, she experienced her first menstrual cycle. The first two days brought only light bleeding and minimal pain, which made her optimistic. However, days three and four brought a surge in pain that fluctuated along with significantly heavier bleeding. Even though the pain was much less severe compared to her previous experiences, the intensity of the flow was unprecedented for her. Fortunately, by day five, the heavy bleeding subsided, and it appears her period is winding down with just a small amount of residual bleeding. Her current medication regimen includes: - Daily: Ritalin 30mg, Fluoxetine 30/20mg - Occasionally: Ibuprofen, Buscopan, Trimipramine - Other: Iron and Vitamin D supplements Her medical history includes high-functioning autism, ADHD, iron deficiency anemia, and migraines with aura. She remains mindful of potential interactions between Fluoxetine and Ibuprofen but has only noticed adverse effects with consistent usage over several days, which was not the case this time. Her primary concerns are about the healing process of the uterus after such surgery and whether it was to be expected that her first period following the operation was so unusually heavy. She notes that no healthcare provider warned her about the intensity of her menstrual flow post-surgery, only that future cycles should be less painful and lighter. She is curious about what changes she might anticipate in her cycles moving forward.

Answers (1)

3/28/2025, 5:20:42 PM

OpenHealth AI

It's common to have variations in menstrual cycles after a significant procedure like laparoscopic myomectomy. What you're experiencing with your first post-surgery period — heavier bleeding and more intense pain — can be attributed to several factors, including hormonal changes and the healing process of your uterus.

Explanation:

After surgery to remove fibroids and perform other interventions in the uterus, your body goes through adjustments. The menstrual cycle can be influenced by the hormonal balance, the physical changes in the uterus, and the healing process. While many women report lighter and less painful periods after fibroid removal, it is not unusual for some to initially experience heavier flows and varying levels of discomfort as their body readjusts.

Next Steps:

1. Monitor Your Cycles: Keep a record of your menstrual flow and pain levels over the next few cycles. This will help you identify any patterns or changes and provide useful information if you consult a healthcare provider later.

2. Pain Management: Continue using ibuprofen as needed for pain relief, but be sure to follow your body’s signals and adjust as necessary. If pain or bleeding remains heavy, try to manage it proactively.

3. Iron Levels: Given your history of iron deficiency anemia, ensure you continue with your iron supplements and monitor your energy levels. Consider discussing with a provider about possibly doing blood tests if heavy bleeding persists, to evaluate your hemoglobin levels.

4. Hydration and Rest: Stay well-hydrated, especially during your period, as this can help manage symptoms. Be sure to rest as needed to help your body during the recovery phase while managing menstrual symptoms.

5. Communicate Concerns: If your bleeding does not become lighter in the next couple of cycles or if you have significant pain or other unusual symptoms, consider reaching out to your healthcare provider to explore further.

It's important to be gentle with yourself as your body heals and adjusts to the changes. If you have further concerns or need clarity on upcoming cycles, don’t hesitate to ask for additional support.