Is it normal to have problems with periods after surgery? I am 30 years old. A year ago I had a 10cm cyst removed along with an ovary and fallopian tube. I did not have a period until six months after surgery. My periods have always been every 28 days and last four days (I've never been on birth control). Since surgery, they have been extremely light and last 10-15 days or more. My last one went 40 days, which prompted a visit to the doctor. An ultrasound indicates that everything is normal. My doctor is thinking of putting me on hormone therapy to "jump-start" my hormones. Is this standard procedure? Also, I am trying to get pregnant. Will I be able to conceive while on hormones?

Chris

It is not uncommon to have some menstrual irregularities after surgery. However, what you describe does not fall into the realm of "normal" abnormality. Six months of no periods following removal of an ovarian cyst is a bit long and would suggest a hormonal imbalance leading to lack of ovulation.

If your doctor has not done so already, I would suggest some blood tests in addition to the ultrasound you have already had. Premature menopause (more correctly called premature ovarian failure) is unlikely at age 30, but it should still be ruled out. A blood test can also reveal signs of thyroid or pituitary dysfunction, another possible cause of menstrual irregularities and infertility. If the thyroid or pituitary gland is not functioning properly, then medication is given to correct the imbalance. Most of the time, this treatment will restore normal cycles as well as fertility.

Abnormalities of the uterine cavity, such as polyps or scar tissue from a prior D&C, may lead to abnormal, prolonged bleeding. A basic ultrasound will not pick these up, but a special ultrasound called saline infusion sonography (or sonohysterography, or, my favorite, "water ultrasound") will. In this procedure, a small amount of sterile saline solution is introduced into the uterine cavity via a very thin tube passed through the cervix, and an ultrasound is then done; the fluid in the cavity makes it easier to see irregularities of the uterine lining. If an abnormality is found, it may be further evaluated and treated by an outpatient surgical procedure called a hysteroscopy (dilating the cervix and inserting a telescope-like instrument into the uterine cavity so the doctor can view the lining directly).

Because your problems have been going on for such a long time, and because you wish to become pregnant (don't forget your folic acid supplements!), I recommend you be completely evaluated before beginning any treatment.