Irregular Periods After Myomectomy- Is it Normal or Alarming?

Are you worried about irregular periods after myomectomy? Well, myomectomy is an effective way to get your menstrual blood flow back on track. The first few cycles might come like a nightmare but once the body adjusts to the new norm, you’ll experience lighter periods with less pain. 

Several body changes after myomectomy are common and observed by almost all women. If you want to have children in the future, then myomectomy can help you remove fibroids along with the preservation of the uterus, unlike the hysterectomy in which the entire uterus is removed.

Here, in this write-up, I’ll share with you all the details of myomectomy, its types, complications, and risks. Moreover, you’ll get the answers to all of your queries regarding the relationship between the menstrual cycle and myomectomy. 

What is Myomectomy?

Uterine fibroids are one of the most common reproductive disorders most women experience. These are noncancerous cellular outgrowths in the uterus which might contribute to heavy vaginal bleeding during the menstruation cycle.

These fibroids may be intramural, serosal, pedunculate, and submucosal based on their location. Myomectomy is an efficient surgical procedure that removes fibroids and also preserves the uterus for future pregnancy.

myomectomy

Usually, women prefer herbal treatments and supplements for fibroid treatment but some opt for surgical procedures. When it comes to surgery, women have two options, those who want to have children in the future are advised to go for a myomectomy.

This is because it not only excises fibroids but also preserves the uterus for future pregnancies. On the other hand, those who don’t want future pregnancies or are done with childbearing opt for a hysterectomy which is the complete removal of the uterus.

If you’ve decided to treat the fibroids medically, then consult your doctor, he’ll help you in choosing the best option for you. Usually, doctors consider the following factors for choosing myomectomy as treatment,

  • Size of the outgrowths
  • Their quantity
  • Type of fibroids

The aforementioned benchmarks are the basis of determining the type of myomectomy to be performed. There are three different types of myomectomies, each with different risks and benefits.

Types of Myomectomy

Surgeons can choose a minimally invasive or open surgery method for the excision of fibroids. Although the surgery has shown great results, in rare cases, these fibroids can grow back. Younger women are more likely to suffer from the regeneration of fibroids. The types of myomectomy include,

Open Myomectomy

The open or abdominal myomectomy is the most effective treatment for large-sized deep fibroids. As the name suggests, the surgeons make an incision into the abdominal region that is generally known as “bikini cut.”  Open myomectomy is major surgery, so the recovery might take a few days or weeks. There is a possibility of the patient to suffer from the following post-surgery complications:

  • Development of wound infection
  • Excessive bleeding
  • Damage to the nearby organs during surgery

However, all of these complications are rare so don’t worry but make sure to visit your healthcare provider for one and a half months after the surgery to avoid any complexity. Patients who want to sustain pregnancy in the future are suggested to have an abdominal myomectomy,

Standard Laparoscopic Myomectomy

This minimally invasive procedure uses a laparoscope for the surgical excision of fibroids. The surgeons make several small incisions in the lower abdominal region. The cavity is then filled with gas and a telescope is used to observe the reproductive system. Several other instruments are then inserted for removing fibroids.

Hysteroscopic Myomectomy

When fibroids are small in size and within a reachable location inside the uterus, this non-surgical method can be easily done. The instruments are introduced through the cervix and this method is exclusively performed for submucosal fibroids.

hysteroscopic-myomectomy

Myomectomy Complications

Due to the availability of herbal and non-surgical treatments of fibroids, a myomectomy is a secondary option. Like other surgeries, myomectomy also has some benefits and complications. Following are some of the rare post-myomectomy complications.

  • Excessive bleeding due to which one might require a blood transfusion.
  • Hemorrhage
  • Formation of clots
  • Scarring in the uterus
  • Following surgery, the patient might encounter an infection that is usually treated with antibiotics.
  • Anaesthetic side effects
  • Damage to the nearby organs
  • Myometrial hematoma
  • Bowel obstruction (rarely)

Irregular Periods After Myomectomy

Women often ask, does myomectomy affect the menstrual cycle or hormones? Well, myomectomy is performed with an aim to remove fibroids which cause heavy vaginal bleeding and painful cramps during the menstruation cycle. In some cases, these fibroids can become a barrier to your ability to conceive as well. Hence, myomectomy can help you preserve your fertility for having children in the future.

irregular-periods-after-myomectomy

Patients with fibroids lose a lot of blood during their monthly cycle. So, most of the women with fibroids become anemic. Doctors usually prescribe iron supplementation to such patients to reduce the risk of post-surgery anemia.

Shrinking fibroids is also a considerable option before the surgery to avoid an extremely invasive method. Usually, doctors advise patients to go through gonadotropin-releasing hormone therapy which reduces the level of estrogen thereby helping in shrinking fibroids. Hence, the shrinking would reduce the risk of any surgical complication.

Many patients experience spotting or heavy bleeding after myomectomy. Prolonged bleeding might be caused due to an infection in the uterus but vaginal discharge is common within the first two weeks of the surgery. Usually, reddish-brown colored spots might appear until the beginning of the first menses phase of the cycle.

But is it normal to have irregular periods after myomectomy? Well, a majority of women experience painful and irregular periods after myomectomy. Irregular menses are those which never come on time. Either they are delayed or they come early. Scarring of the uterus (usually due to an infection or surgery) and fibroids can also be a reason for secondary amenorrhea.

You can expect your first period after myomectomy either late or early. Many patients experience the most painful cramps during their first period after myomectomy.

It might take a few cycles for things to come back to normal. Excessive blood discharge during the first period can make you anemic. So, doctors usually prescribe iron supplements to avoid anemia.

Irregular periods after myomectomy are quite normal but after one to two cycles, your body will establish the new norm. The fibroids which were once responsible for heavy bleeding are removed, so definitely your menses will be lighter and less painful than they were before.

However, the first few cycles are an exception.

Takeaway

Any surgery performed in your pelvic region can easily interfere with the working of your reproductive organs. Myomectomy is an effective way of removing fibroids and is well-known for controlling excessive menstrual discharge.

However, irregular periods after myomectomy are common and a few of your cycles, in the beginning, can be early or late. Once the body adjusts to the new norm, your menstrual flow will gradually become lighter and periods will be less painful.

All in all, myomectomy can help you get rid of that heavy menstrual flow and might also give you a chance to get pregnant. In some cases, the fibroids are known to come back after the surgery. Re-growth will produce the same symptoms as the pre-existing fibroids did. 

FAQs

How long does it take for uterus to heal after myomectomy?

The duration of healing after myomectomy might vary with the type of procedure performed. On average, the recovery can take place within one and a half months of the surgery, and the hospital stay can last for 4-5 days. Post-surgical instructions include avoiding all kinds of heavy lifting and exercises for at least one and a half months. Also, try to refrain from sexual intercourse until your surgeon allows you to resume.

When should I expect my period after myomectomy?

Initially, patients suffer from light bleeding, spotting, or staining till the first two months after the procedure is done. Many women experience irregular periods after myomectomy. You can not expect your first periods to be on time. They’ll either be late or earlier and can be very painful. Furthermore, the bleeding can be heavier than you’ve had before.

Can myomectomy be performed during menstruation?

Most doctors prefer to perform a myomectomy soon after menstruation. Usually, surgeons do not perform myomectomy during menses because of heavy blood loss. However, studies reveal that no phase of the reproductive cycle has an effect on the procedure.

How long does bleeding last after myomectomy?

Post-myomectomy bleeding can take place up to 15 days after the surgery. The vaginal discharge can be reddish-brown in color and would slowly diminish. Swelling is also common after myomectomy and may go down within a few days or weeks. It will take you at least 4-6 months to completely recover after a myomectomy.

Can fibroids return after myomectomy?

Yes, in some cases fibroids can re-grow after myomectomy. This growth is highly influenced by aging. Usually, women near menopause are unlikely to experience the re-growth of fibroids after the surgery. On the other hand, younger women might experience the return of fibroids after myomectomy. 

Is pregnancy possible after a myomectomy?

Yes, myomectomy involves the excision of fibroids only and not the uterus. However, the chances of pregnancy depend on several factors such as age, quantity, type and size of fibroids, and patient’s history. So, the women who want to sustain pregnancy in the future can opt for myomectomy.

Mehrosh Ahmer

Mehrosh Ahmer

My name is Mehrosh Ahmer and I’m currently a student of MBBS at Jinnah Sindh Medical University. My passion for studying the wonder that is the human body and the desire to give back to my society has led me to pursue a career in medicine. As I research, I learn more about my field, and it improves my understanding. This is why I enjoy writing the articles so that more people might get to read about subjects that they otherwise might never encounter.

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