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Suggest Treatment For Intermittent Bleeding, Spotting And Pelvic Pain After Fibroid Resection
Question: Hi Doctor,
As through my previous history i had fibroid resection on 6th may, this is my second menstrual cycle, and today is the 9th day. Bleeding is happenning in intervals. It is not very heavy but spotting. After the surgery the first cycle was ok and lasted for 6 days. But this time the period diesnt seem to stop. Is it normsl after the surgery and will stop? Im slso hving little lower pelvic pain right under my uterus. Please advise. Shen will i see inprovements in my prolonged period
As through my previous history i had fibroid resection on 6th may, this is my second menstrual cycle, and today is the 9th day. Bleeding is happenning in intervals. It is not very heavy but spotting. After the surgery the first cycle was ok and lasted for 6 days. But this time the period diesnt seem to stop. Is it normsl after the surgery and will stop? Im slso hving little lower pelvic pain right under my uterus. Please advise. Shen will i see inprovements in my prolonged period
Brief Answer:
Prolonged spotting post hysteroscopic fibroidectomy
Detailed Answer:
Hello,
Thanks for the query to healthcare magic.com,
It was indeed the right thing to get a submucosal fibroidectomy done hysteroscopically which is done with a versa point and the endometrium as well is being shaved.
The menses generally return normally in 2-3 months as there could be areas of baseless layer injury sometimes which shall take time to heal and don't grow endometrium in those areas and tend to remain bald and hence often lead to prolonged spotting or even inter menstrual spotting. But generally it is seen that the woman is placed on oestrogens like premarin for at least 10 days from the day of surgery to promote endometrial growth and the XXXXXXX is being practiced for atleast 3 cycles.
As i feel it has not been prescribed, this spotting is as expected and shall subside with subsequent menstrual cycles. However if the spotting and bleeding is nagging you, then you may consider antifibrinolytic therapy like TAB TRANEXAMIC ACID 500mg twice a day for 3 days to help stop the bleeding and once stopped you can omit it. Its safe and is usually first choice for interenstrual or unexplained bleeding.
you can discuss with your physician and can get it prescribed. it shall help you get over your concern here.
Regards
Prolonged spotting post hysteroscopic fibroidectomy
Detailed Answer:
Hello,
Thanks for the query to healthcare magic.com,
It was indeed the right thing to get a submucosal fibroidectomy done hysteroscopically which is done with a versa point and the endometrium as well is being shaved.
The menses generally return normally in 2-3 months as there could be areas of baseless layer injury sometimes which shall take time to heal and don't grow endometrium in those areas and tend to remain bald and hence often lead to prolonged spotting or even inter menstrual spotting. But generally it is seen that the woman is placed on oestrogens like premarin for at least 10 days from the day of surgery to promote endometrial growth and the XXXXXXX is being practiced for atleast 3 cycles.
As i feel it has not been prescribed, this spotting is as expected and shall subside with subsequent menstrual cycles. However if the spotting and bleeding is nagging you, then you may consider antifibrinolytic therapy like TAB TRANEXAMIC ACID 500mg twice a day for 3 days to help stop the bleeding and once stopped you can omit it. Its safe and is usually first choice for interenstrual or unexplained bleeding.
you can discuss with your physician and can get it prescribed. it shall help you get over your concern here.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello Dr. XXXXXXX
I started taking tranxemic acid twice a day as you advised. but as mentioned earlier, today is now the 10th day. It is not bleeding heavily just spotting . I want to get back to normal . This is my second menstrual cycle after fibroid resection. when should the spotting stop? also I ma having lower pelvic pai. Is it because of the operation I had ?
Please suggest. I am really worried.
Regards,
XXXX
I started taking tranxemic acid twice a day as you advised. but as mentioned earlier, today is now the 10th day. It is not bleeding heavily just spotting . I want to get back to normal . This is my second menstrual cycle after fibroid resection. when should the spotting stop? also I ma having lower pelvic pai. Is it because of the operation I had ?
Please suggest. I am really worried.
Regards,
XXXX
Brief Answer:
answered
Detailed Answer:
Hello,
Thanks for the follow up.
There is no need to be worried as there is nothing serious here. The surgical healing in fibroid section can take 1-2 months to heal often and you may experience mild pain off and on and thats normal. you can safely use NSAIDS for pain relief.
As you bleeding has reduced to spotting now, it is suggested that you continue tranexaic acid for 2 more days and then you may stop. You have to keep your hydration levels good as tranexamic acid can cause dehydration and often headaches which can be avoided.
A follow up ultrasound pelvis, transvaginal preferably, should be considered after the bleeding stops to evaluate the status of surgical site and endometrialisation.
Regards
answered
Detailed Answer:
Hello,
Thanks for the follow up.
There is no need to be worried as there is nothing serious here. The surgical healing in fibroid section can take 1-2 months to heal often and you may experience mild pain off and on and thats normal. you can safely use NSAIDS for pain relief.
As you bleeding has reduced to spotting now, it is suggested that you continue tranexaic acid for 2 more days and then you may stop. You have to keep your hydration levels good as tranexamic acid can cause dehydration and often headaches which can be avoided.
A follow up ultrasound pelvis, transvaginal preferably, should be considered after the bleeding stops to evaluate the status of surgical site and endometrialisation.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello Dr XXXXXXX
Iam 39 years old and yet to have a baby. I was having too much periods , pain and bleeding between periods from last two years. Then I consulted a Doctor who said I have couple of fibroids( few intramural & one submucosa under my uterus. He asked to get fibroid resection as the whole cannot be taken out as it might damage my uterus . So after the surgery he said he shaved of the 5 cm fibroid significantly which should improve my periods. After the surgery this is the second period I am having and today is the 11th day, the first five days were heavy like normal but after the 6 th day until today it is spotting but didnt stop completely.
Doctor I want to know since ive done the surgery , why my bleeding is still not stopped?? I thought after the surgery my problem will be ok.
What blood is this? Is it still the operational blood or is it coming out of the fibroid?? I very worried and stressed. When will this stop? As again after three weeks my third periods will come?? When will see the improvement.
Lastly Doctor what are chances of the remaining shaved fibroid to regrow back
Please advise
Regards,
XXXX
Iam 39 years old and yet to have a baby. I was having too much periods , pain and bleeding between periods from last two years. Then I consulted a Doctor who said I have couple of fibroids( few intramural & one submucosa under my uterus. He asked to get fibroid resection as the whole cannot be taken out as it might damage my uterus . So after the surgery he said he shaved of the 5 cm fibroid significantly which should improve my periods. After the surgery this is the second period I am having and today is the 11th day, the first five days were heavy like normal but after the 6 th day until today it is spotting but didnt stop completely.
Doctor I want to know since ive done the surgery , why my bleeding is still not stopped?? I thought after the surgery my problem will be ok.
What blood is this? Is it still the operational blood or is it coming out of the fibroid?? I very worried and stressed. When will this stop? As again after three weeks my third periods will come?? When will see the improvement.
Lastly Doctor what are chances of the remaining shaved fibroid to regrow back
Please advise
Regards,
XXXX
Brief Answer:
answered
Detailed Answer:
Hello,
After the surgery ideally a ultrasound transvaginal and a sonosalpingography should have been done to evaluate the status of the operated fibroid if complete submucosal extension has been shaved off or there is still some left causing a bump in the endometrial lining which can be the possible cause for the continued bleeding. This is very important for assessment as complete endometrialization over the raw area of fibroid may not have occurred and that is what is the most probable reason for continued spotting in form of shedding endometrium due to continuous breakage of lining at that raw area.
If surgery has been to the maximum extent possible then the bleeding should have stopped with tranexamic acid course. I suggest you visit your treating gynaecologist for discussing the same and copy for sonosalpingogram for evaluation of the endometrial lining.
Lastly, fibroid if not been completely removed is likely to grow back again, yes , so it is usually advised that if pregnancy is contemplated then it should be planned after 3 months of surgery provided healing is complete.
Regards
answered
Detailed Answer:
Hello,
After the surgery ideally a ultrasound transvaginal and a sonosalpingography should have been done to evaluate the status of the operated fibroid if complete submucosal extension has been shaved off or there is still some left causing a bump in the endometrial lining which can be the possible cause for the continued bleeding. This is very important for assessment as complete endometrialization over the raw area of fibroid may not have occurred and that is what is the most probable reason for continued spotting in form of shedding endometrium due to continuous breakage of lining at that raw area.
If surgery has been to the maximum extent possible then the bleeding should have stopped with tranexamic acid course. I suggest you visit your treating gynaecologist for discussing the same and copy for sonosalpingogram for evaluation of the endometrial lining.
Lastly, fibroid if not been completely removed is likely to grow back again, yes , so it is usually advised that if pregnancy is contemplated then it should be planned after 3 months of surgery provided healing is complete.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank Dictor, so will this spotting not stop forever?yes it is right that my fibroid is not removed just part of it is shaven off. But does that mean I will keep on bleeding ir the spotting will stop,
Secondly within how many months it can grow back?
Dictor I live in Australia and here the doctors prefer not touching the uterus if you dun hve a family yet.
So thats the reason he just shaved of some part if it. He said I should see improvements in my 3 cycles, but he didnt tell me anything about the prolonged spotting. I called him yesterday and he said it mught be the operational blood. And also said he would get the ultrasound done in august( after three months of surgery)
The painis also there on & off... Im just getting frustrated niw
Please help me
Regards
Secondly within how many months it can grow back?
Dictor I live in Australia and here the doctors prefer not touching the uterus if you dun hve a family yet.
So thats the reason he just shaved of some part if it. He said I should see improvements in my 3 cycles, but he didnt tell me anything about the prolonged spotting. I called him yesterday and he said it mught be the operational blood. And also said he would get the ultrasound done in august( after three months of surgery)
The painis also there on & off... Im just getting frustrated niw
Please help me
Regards
Brief Answer:
answered
Detailed Answer:
Hello,
No the bleeding should not continue for long as the clotting mechanism takes over soon and the raw areas are clotted sooner. This is more likely to be the endometrial irregular shedding due to possible inability to grow over the raw area.
If after taking three days of tranexamic acid, your bleeding has not reduced then you should be placed on Birth control pills for excessive bleeding control. You can use low dose OC pills AND take it in the following schedule...
1st day 1 pill thrice a day for 3days then twice a day for 2 days and then once a day for 2 days. Then you may continue the remaining pack once a day till it ends and the added advantage shall be your next menses would occur after you finish the pack ( within5-7 days).
Regards
answered
Detailed Answer:
Hello,
No the bleeding should not continue for long as the clotting mechanism takes over soon and the raw areas are clotted sooner. This is more likely to be the endometrial irregular shedding due to possible inability to grow over the raw area.
If after taking three days of tranexamic acid, your bleeding has not reduced then you should be placed on Birth control pills for excessive bleeding control. You can use low dose OC pills AND take it in the following schedule...
1st day 1 pill thrice a day for 3days then twice a day for 2 days and then once a day for 2 days. Then you may continue the remaining pack once a day till it ends and the added advantage shall be your next menses would occur after you finish the pack ( within5-7 days).
Regards
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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