Delayed Period After Myomectomy and Fibroids: What to Know

If your period is late after a myomectomy (surgery to remove uterine fibroids), you’re not alone. Cycle changes are common during recovery. Most delays are temporary, but it’s important to know what’s expected, what’s not, and when to call your clinician.

How soon should your period return after myomectomy?

Many people see their first postoperative period within 4–6 weeks, though timing varies based on the surgical approach, preoperative medications, and your baseline cycle.

Typical timelines by surgical approach

• Hysteroscopic myomectomy (fibroids removed through the cervix): Periods often resume within 4–6 weeks.
• Laparoscopic or robotic myomectomy: Expect a period in about 4–6 weeks, occasionally closer to 6–8 weeks.
• Open/abdominal myomectomy: Recovery is longer; the first period frequently returns within 6–8 weeks.

Your exact timeline can differ, especially if the uterine cavity was entered or if multiple/deep fibroids were removed.

Medications that can shift your cycle

Before surgery, some patients receive medications such as gonadotropin-releasing hormone (GnRH) agonists (for example, leuprolide) to shrink fibroids and reduce bleeding. These drugs temporarily shut down ovarian hormone production and can stop periods. If used, your cycles may take several weeks to a few months to fully resume after the last dose.

Why your period may be late after myomectomy

• Normal postoperative reset: The uterus needs time to heal. Inflammation, changes to the uterine lining, and temporary hormonal shifts can delay ovulation and menstruation.
• Pre-op hormone therapy: GnRH agonists and some other hormonal treatments can suppress periods beyond the surgery date.
• Stress and recovery: Physical stress, anesthesia, pain, and sleep changes can disrupt the hypothalamic–pituitary–ovarian axis, delaying ovulation.
• Weight change, illness, travel: Common life factors can postpone a period even in the absence of surgery.
• Pregnancy: If you’re sexually active, don’t assume a delay is only from surgery. Test for pregnancy, especially if you’re beyond 4–6 weeks without a period.
• Intrauterine adhesions (Asherman syndrome): Uncommon but possible after procedures involving the uterine lining—more so when the cavity is entered or with hysteroscopic removal of submucosal fibroids. Signs include very light or absent periods with cyclic cramping.
• Other conditions: Thyroid disorders, elevated prolactin, polycystic ovary syndrome (PCOS), or premature ovarian insufficiency can also cause missed periods.

When is a delayed period not normal?

Call your surgeon or gynecologist if you experience:

• No period by 8 weeks after surgery (earlier if you’re worried or had the uterine cavity entered).
• Severe pelvic pain, fever, chills, or foul-smelling discharge.
• Very heavy bleeding (soaking more than 2 pads per hour for 2 consecutive hours), large clots, or dizziness.
• Persistent very light or absent periods accompanied by monthly cramping (possible adhesions).

Could you be pregnant? Testing and contraception after myomectomy

Because ovulation can resume before your first postoperative period, pregnancy is possible unless you’re using contraception. Many surgeons advise avoiding pregnancy for at least 3 months—and sometimes up to 6 months—after myomectomy to allow the uterus to heal. Ask your surgeon for your specific timeline. If you’re late, take a home pregnancy test. If positive, contact your obstetrician-gynecologist to discuss next steps. Some patients will be advised to plan a cesarean birth in future pregnancies depending on the size and location of uterine incisions.

What to expect from periods after fibroid removal

• Flow may change: If fibroids were causing heavy bleeding, many people notice lighter, shorter periods after recovery.
• Cramping may improve: Removal can lessen bulk-related pain and pressure.
• Irregularity is common initially: Cycles often stabilize over 2–3 months.
• Fibroids can recur: New fibroids can develop over time, potentially altering bleeding again. Keep up with follow-up visits.

How doctors evaluate a delayed period after myomectomy

• Pregnancy test: First-line for anyone late and sexually active.
• Clinical exam: Checks healing and rules out infection.
• Ultrasound: Assesses the uterine lining, looks for fluid, new fibroids, or postoperative changes.
• Targeted labs: Thyroid-stimulating hormone, prolactin, and others if indicated.
• Saline infusion sonography or hysteroscopy: If intrauterine adhesions are suspected, direct visualization and treatment may be recommended.

Practical tips while you wait for your period

• Track symptoms and dates (pain, spotting, temperature, home tests) to share with your clinician.
• Use reliable contraception until your surgeon clears you to conceive.
• Stay hydrated, resume gentle activity as advised, and prioritize sleep—these support hormone regulation.
• If you had pre-op GnRH therapy, ask when to expect menses to return based on your last dose.
• For heavy bleeding once cycles resume, ask about options such as NSAIDs or tranexamic acid; hormonal methods may also regulate flow if appropriate for you.

Key takeaways

• A period within 4–8 weeks after myomectomy is common, depending on surgical approach and medications.
• Delays can result from normal healing, stress, or pre-op hormonal suppression—but always rule out pregnancy.
• Contact your clinician if there’s no period by 8 weeks, or sooner with worrisome symptoms.
• After recovery, many people experience lighter, more predictable periods.

Trusted sources and further reading

• American College of Obstetricians and Gynecologists (ACOG) – Uterine Fibroids: https://www.acog.org/womens-health/faqs/uterine-fibroids
• National Institutes of Health, Office on Women’s Health – Uterine Fibroids: https://www.womenshealth.gov/a-z-topics/uterine-fibroids
• Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) – What are Fibroids?: https://www.nichd.nih.gov/health/topics/uterine/conditioninfo/fibroids
• National Health Service (NHS) – Myomectomy (Overview and Recovery): https://www.nhs.uk/conditions/fibroids/treatment/
• U.S. Food and Drug Administration (FDA) – Information on GnRH medicines (e.g., leuprolide): https://www.fda.gov/drugs

This article is for general education and does not replace personalized medical advice. If you have concerns about your recovery, contact your healthcare professional.