Gastric sleeve surgery is a complex procedure that removes about 80% of the stomach, resulting in significant metabolic and physical changes. For female patients, a common logistical question involves the timing of the procedure relative to their menstrual cycle. While surgery is scheduled months in advance, a patient’s cycle can sometimes coincide with the date. This often leads to uncertainty about whether the operation can still proceed.
Scheduling Surgery During Menstruation
If a patient’s menstrual cycle aligns with their scheduled gastric sleeve date, the surgery does not require cancellation. Menstruation is not a medical contraindication, meaning it does not make the operation unsafe to perform. The primary concern for the surgical team is patient comfort and ensuring proper hygiene protocols are followed.
Patients should inform the bariatric coordinator or surgical team immediately if their period will fall on the date of surgery. This communication allows the team to make minor logistical adjustments for a smoother experience. On the day of surgery, patients must remove all personal menstrual products, such as tampons or menstrual cups. This is necessary for sterile field maintenance and due to the use of a catheter during the procedure.
The hospital staff is prepared for this situation and will provide specialized, highly absorbent pads and mesh underwear for use during and immediately after the operation. Nurses prioritize patient dignity and cleanliness throughout the surgical process and recovery. Although the surgery can proceed, medical teams prefer to avoid the first few days of a heavy flow, if possible, to maximize patient comfort.
Clinical Considerations for Operating During a Period
The preference to avoid operating during a patient’s period is rooted in clinical and comfort-related factors, though it rarely warrants postponement. Patient comfort is a major consideration, as cramping associated with menstruation can compound the typical post-operative pain from surgical incisions. While pain medication is part of recovery, managing two sources of pain simultaneously can be challenging.
A technical concern involves the use of a urinary catheter, which is often inserted during the procedure to monitor fluid output. Catheter use, even for a short time, increases the risk of a Catheter-Associated Urinary Tract Infection (CAUTI). The presence of menstrual blood provides a potential source of bacteria near the catheter insertion site, which can increase the risk of this post-operative infection.
Anesthesiologists closely monitor a patient’s blood loss during the surgery. Although menstruation does not significantly increase surgical blood loss, the presence of menstrual flow can make it more difficult to accurately estimate other intraoperative blood loss. Furthermore, an existing heavy flow or pre-operative anemia from the cycle may complicate the baseline assessment of hemoglobin levels tracked before and after the procedure.
Managing the Menstrual Cycle Before Surgery
When a patient anticipates a conflict between their surgical date and their menstrual cycle, proactive management can often resolve the issue. Patients who use hormonal birth control, such as the pill, may be able to safely manipulate their cycle to delay or skip their period. This is typically done by running two or more active pill packs together without taking the placebo pills.
Any attempt to alter the cycle with medication must be discussed with both the gynecologist and the bariatric team, as sudden hormonal changes can carry risks. Some bariatric surgeons recommend patients discontinue certain hormonal contraceptives containing estrogen before surgery due to an increased risk of blood clots. Careful coordination is required to balance the need for cycle management with the safety protocols for the operation.
If the period cannot be safely avoided or delayed, patients should establish a clear plan for managing hygiene and comfort upon arrival at the hospital. Discussing cramp management and ensuring access to appropriate hospital-grade pads with the nursing staff will alleviate anxiety. Ultimately, the surgery will proceed, and the medical team will ensure the patient’s comfort and cleanliness are maintained throughout their stay.