Uterine fibroids are a common cause of heavy or irregular menstruation in women. The main purpose of a myomectomy is to minimize the gynecological symptoms caused by uterine fibroids. The process of coming to a decision about undertaking a major surgery like this can be quite difficult.
So, seeing the symptoms more exaggerated rather than being cured after the surgery as a side effect can be utterly terrifying. Nothing concerns us more than seeing a problem getting worse, especially after having tried to fix it.
So, what causes this kind of period after myomectomy? Why do the symptoms actually get worse?
Myomectomy is a common procedure around the world, especially in women of child-bearing age. The symptoms after the myomectomy surgery can vary widely between 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.
The heavy bleeding and pain in the first two periods after myomectomy are normal and usually, there is nothing to worry about. However, there may be other complications that can cause similar symptoms.
But despite this, myomectomy is the most preferable option for the treatment of uterine fibroids. It is preferred over a possible compulsory hysterectomy in the future.
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What Causes Heavy Period after Myomectomy?
Myomectomy is a major and complex procedure. In a myomectomy, the surgeon removes uterine fibroids and then reconstructs the uterus and its layers. The objective is to remove as much of the problem-causing fibroids as possible, so most of the time this involves removing much of inner uterine tissue as well. As a result, the uterine tissue becomes scarred and inflamed.
In the course of the weeks following the procedure, the usual menstrual cycle again agitates this scarred tissue which may cause more bleeding. It is also believed that the removal of uterine fibroids may cause a change in the hormonal circulation during menstruation, causing heavy flow during periods.
This heavy period only lasts for the first few menstrual cycles, as the uterus heals and the hormone levels in the body once again become balanced, the periods become lighter and much better than before.
Relation Between Myomectomy and Menstruation
Fibroids cause the oversecretion of hormones like estrogen, causing their levels in the blood to rise. This in turn causes the endometrial lining to become thicker and denser. During menstruation, this thick endometrial layer sheds, causing heavy periods and severe pain. Uterine fibroids can also cause other problems such as anemia and infertility
So, after the removal of these fibroids through myomectomy, the painful bleeding is supposed to heal.
But most women report heavy bleeding in the 1st or 2nd period after myomectomy.
This may be confused with post-operative bleeding if the period occurs just after surgery. The bleeding comes from scar tissues that 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 starts to gradually get lighter. This indicates the myomectomy to be useful for the patient.
Things to look out for after Myomectomy:
If you have already had a myomectomy or are wondering what happens after you do, there are some important things you should know. In both cases, the following points will help you out.
Normal Side Effects:
As with any surgery, there are common side effects and symptoms you might face after a myomectomy. These are normal symptoms after myomectomy and do not require a doctor’s consultation.
These symptoms 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.
It’s also important to know about some complications that may arise after a myomectomy. These are usually rare and their occurrence varies according to age, physical features, genetic factors, etc.
Some common complications 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.
Treatment of Post-Myomectomy Symptoms:
In case of post-surgical complications, consult your gynecologist and follow their advice. They might suggest the following treatments:
- 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 may give you anticoagulant medications for blood clots according to the requirement.
How to Manage Period after Myomectomy in the Long Run:
For better reproductive health and to avoid post-myomectomy complications, its important to know the following points:
For Fast Recovery at Home:
- 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 strenous 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. is good during post-myomectomy recovery. Also, drink lots of 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.
- Have regular check-ups or follow-ups.
- Always complete the full course of antibiotics even if you feel better.
- Call the doctor in case of an emergency. 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:
- 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 your BMI.
- Doing meditation or yoga helps in improving reproductive health to a great extent. This requires patience and can deliver amazing results.
6 Home Remedies for Period Troubles:
So, the period after myomectomy is thankfully nothing to be worried about. But that doesn’t make it any less painful or uncomfortable. But we’ve got you covered. Here are some of the best remedies you can try at home to treat irregular, heavy, or painful menstruation.
For the period faced just after myomectomy you can tr the following remedies 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, women are still led to believe that heavy pain during periods is normal. And, they should learn to deal with it as previous generations did. Not only is this a very archaic belief, but it can also lead to severe health complications.
Women also don’t talk about menstrual problems because it is deemed inappropriate. So, young girls aren’t given the necessary knowledge about reproductive health during their formative years and so the women continue 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 or myomectomies. Hence, they keep suffering without knowing that there is actually a better alternative.
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.
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. In this case, awareness and communication are very important. The more people are aware that better healthcare options exist for reproductive health, the lesser the plight of the women will be.