Period After Myomectomy: Things You Need to Know

The main purpose of a myomectomy is to decrease your gynecological symptoms caused by uterine fibroids. The decision to do a major surgery like this can be very difficult. 

Moreover, seeing the symptoms exaggerated after surgery as a side effect can be terrific. The most concerning conditions are related to periods, fertility, and reproductive health in general.

So, how is the period after myomectomy?

Myomectomy is a common procedure throughout the world, especially in women of reproductive age. The post myomectomy symptoms vary widely among women according to their biological makeup. The 1st or 2nd period is usually reported to be heavy bleeding with severe pain. However, the periods get lighter within a few months.

There are other complications too. But often myomectomy is the most preferable option in order to prevent a compulsory hysterectomy in the future. To know more about this, scroll to the segments below. 

Relation Between Myomectomy And Menstruation

Fibroids cause estrogen levels to rise. This in turn causes the endometrial lining to thicken up. Since the endometrial lining sheds during menstruation, heavy and painful bleeding results. 

So, after the removal of fibroids through myomectomy, the painful bleeding is supposed to heal.

period-after-myomectomy

But most women report heavy bleeding in the 1st or 2nd period after myomectomy. 

This may be confused with postoperative bleeding if the period occurs just after surgery. Scar tissues are formed in the places of the uterus from where fibroids are removed. 

And this takes approximately 6 months to heal.  After that, the period will be lighter gradually. This indicates the myomectomy to be useful for the patient.

Post-Myomectomy Troubles And A Bit Of Advice

You may have already had a myomectomy or wondering what will happen after you do. In both cases, the following points will help you out.

Normal Side Effects

The normal symptoms after myomectomy which do not require a doctor’s consultation include:

  • Itching, pain, and swelling just around the site of the incision
  • Nausea, vomiting, back pain, and headache are common
  • General anesthesia may be given instead of spinal anesthesia in some cases. A sore throat can occur due to the windpipe placed during surgery
  • Light vaginal bleeding after the surgery
  • Abnormal bowel movements and constipation occur quite often
  • Fatigue and tiredness due to the effects of anesthesia.

Complications (Reasons, Severity, and Solutions)

The complications arising after myomectomy can be many. This varies according to age, physical features, genetic factors, etc.

Severity And Reasons

The common features with their reasons and degree of severity are as follows:

  • Hemorrhage due to injury/damage in adjacent organs to the uterus during operation.
  • Multiple blood clots due to hemodynamic disorder. These can form emboli and move to distant blood vessels and tissues.
  • Infection at the site of incisions. These can deteriorate if not treated immediately.
  • Recurrence of fibroids is seen in many cases. This occurs in younger women and adolescent girls more. If the fibroids are microscopic then complete removal of them is not always possible. Fibroids contain more estrogen and progesterone receptors. This in turn promotes the growth of more fibroids.
  • Very rarely women may go into menopause and stop menstruating. The exact phenomenon of this is unknown.
  • Excessive diathermy (direct heating) during the surgery can cause a uterine rupture during future pregnancies.
  • Iron deficiency anemia can result from excessive loss of red blood cells as bleeding.
  • Adhesions develop from scar tissues at the sites of fibroid removal.  This can lead to problems with fertility, chronic pelvic pain, intestinal obstruction, etc.

Solutions

In case of post-surgical complications, you can adopt the following measures concerning your symptoms:

  • Antimicrobial drugs are used according to the infection. Broad-spectrum antibiotics are often used.
  • During the 1st few painful periods, over-the-counter pain medicines can help.  Like acetaminophen, ibuprofen, etc. Birth control pills help to combat heavy bleeding.
  • A diet rich in iron helps to fill up the iron deficiency caused due to bleeding. Like, beef, legumes, green leafy vegetables, etc.
  • Although not confirmed, but vigorous exercise for 3-4 hours per week is very useful. It is seen to prevent the recurrence of fibroids in studies. But this should be done after completely healing post-surgery.
  • Internal bleeding may require a blood transfusion. Call the doctor and seek help fast in case of such emergencies.
  • The doctor will give anticoagulant medications for blood clots according to the requirement.
  • You can confirm from the doctor about the use of adhesion preventions during surgery.

In The Long Run

For better reproductive health and to avoid post-myomectomy complications, the following points are necessary:

Recovering Fast At Home By

  • Getting adequate sleep to give away tiredness.
  • Walking daily for good blood circulation.
  • Avoid medium to heavy weights lifting, including babies for a few weeks.
  • Avoiding effortful activities and aerobic exercises until healed fully.
  • Ask your doctor when it’s okay to have sex after surgery.
  • Taking low-fat foods like boiled fish and chicken, yogurt, etc. will be good in post-myomectomy. Also, drink fluids.
  • Having lots of fiber-rich foods. This will help in constipation.
  • Keeping the incision site dry and clean. Change the bandage regularly. Wear loose clothing.
  • Having regular check-ups or follow-ups.
  • Always complete the full course of antibiotics even if you feel better.
  • Call the doctor in case of emergency signs. This includes heavy and painful bleeding, profuse vaginal discharge, etc. Be alert for signs of infection and inflammation like fever, swelling, warmth, pus draining from the incision, etc.

Maintaining A Good Reproductive Health By

  • Eating high fiber-rich foods. This will hold on to the estrogen in the intestinal lumen and prevent reabsorption into the blood. The extra metabolized estrogen will then pass out from the body with stools. The right amount of estrogen is necessary for the prevention of fibroids, cysts, etc.
  • Avoid red meat and processed foods. These increase the estrogen level in the blood and promote the growth of fibroids.
  • Avoid refined sugar to maintain normal blood glucose levels. Diabetes Mellitus patients are more prone to develop fibroids.
  • Doing a regular exercise or vigorous exercise for a few hours per week. Also, check the BMI.
  • Doing meditation or yoga helps in improving reproductive health to a great extent. This requires patience and is optional.

Home Remedies Especially For Periodic Troubles

For the irregular periods faced just after myomectomy one can take the following measures at home:

  • Hydrate yourself with electrolyte-rich fluids like coconut water
  • Limit cheese and other dairy products that increase estrogen levels. High estrogen levels during menstruation is also responsible for pain.
  • Vitamin C-rich foods like orange, tomato, red and green peppers, etc. combat iron loss.
  • Raw papayas help to regulate uterine contractions, thus controlling periodic pain. Ginger tea can help with irregular periods as it maintains hormonal equilibrium. Herbal teas are very relaxing and aid in relieving periodic pain too.
  • A heating pad or hot water bottle can make the uterine muscles relax. This will also reduce the pain.
  • Massaging regularly with pure aromatic essential oils can reduce menstrual cramps too.

Stigma Around Myomectomy And Periods

Unfortunately, many women in rural areas are told that heavy pain during periods is normal. And, they should learn to deal with it as previous generations did. 

People don’t talk about the problems and so women keep suffering from a young age.

After visiting the healthcare providers many women are given just two options- pills or hysterectomy. Most women of reproductive age don’t want their uterus to be removed completely by hysterectomy. 

So, they choose birth control pills, but this is no permanent solution for fibroids. Also, it’s not an option in case anyone wants to be pregnant.

Most people have no idea about fibroids and myomectomy. Hence, keep suffering for wanting to preserve their uterus.

FAQs

Which is the safest myomectomy with the least complications?

Nowadays laparoscopic myomectomy is more preferred over abdominal myomectomy. It decreases the chance of bleeding during the operation and other complications. It has a few limitations too.

Is it normal to face severe menstrual bleeding just after a myomectomy?

It is a common symptom in many women but you need to consult your doctor immediately. The period will be better subsequently.

What are endometriosis Vs Fibroids?

Endometriosis occurs when the lining of the endometrium is found elsewhere in the proliferated state. Like, the ovaries, fallopian tubes, etc. On the other hand, fibroids are benign tumors of the endometrial smooth muscle cells. These are also known as leiomyomas.

Is GnRH (Gonadotropin-Releasing Hormone) safe before myomectomy?

GnRH is used to shrink the size of fibroids before surgery. Now, surgeons don’t usually recommend it unless needed. It’s because of producing side effects like decreased libido, mood swings, headache, etc. in some women.

How long does it take to heal after a myomectomy?

It usually takes 4-6 weeks to get back to daily activities. To get completely healed, it takes around 3-6 months. Remember, it depends on your regular follow-ups.

How is a myomectomy different from a hysterectomy?

Myomectomy is the removal of fibroids from the uterus and then suturing it back. On the other hand, hysterectomy is the complete removal of the uterus. You won’t have a period and can neither get pregnant after a hysterectomy.

Inference

The period after myomectomy can be complicated for some and very easy to handle for others. No matter what the situation is, there are ways to improve.

Fibroids are very common and many women are asymptomatic or face very few symptoms. They are also able to get pregnant without any surgery or medication.

But a lot of women require myomectomy to preserve and continue their reproductive health.  So, with the demand, many studies are being developed on this too.

Fauzia Jasia

Fauzia Jasia

I am Samiha, a student of Medicine, an aspiring writer and a seeker of Truth. I hope that the small efforts we put for the general benefit will guide us to fulfillment.

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