First period after gastric sleeve

Gastric sleeve is a major surgery that is going to affect your body. As a woman, you may ask yourself if this operation will influence your monthly cycles. Is your first period after gastric sleeve surgery going to be shorter, longer, or remain the same? Also, the pain level and the flow of your menstruation could be among your concerns. Lastly, you may need to know how to safely deal with both period and surgical pain.

The truth is, your period length or flow might in fact change. In the article, we are explaining, step by step, how your first period after gastric sleeve may alternate. We are also giving you some useful information on different ways this treatment is going to affect your menstrual period weeks and months after surgery.

Can gastric sleeve affect your period?

Yes, and in a good way! Obese women may experience irregular, sporadic, or missed periods. The great news is that a weight loss of at least 5% can reverse many problems related to obesity. (1) Weight loss may affect hormonal levels and this eventually affects menstrual cycles. While your body is rearranging the cycle, you may encounter irregular periods and different flows. After a few months, your body will adapt to the new menstrual cycle.

If you had hormonal problems before the surgery, such as PCOS (Polycystic Ovary Syndrome), you need to see a gynecologist regularly. PCOS is a hormonal disorder that has no known reason lying behind it. However, studies show that many obese women suffer from PCOS and that excess weight plays a huge role in PCOS revealing itself. (2) If you were diagnosed with PCOS, your weight loss after gastric sleeve treatment is highly likely to help you with your menstrual cycle by regulating it.

Apart from that, there is also one more thing that you may encounter: being late on your period because of stress. Stress is a factor that affects the menstrual cycle. Having the surgery might put your mind or body under stress and it might affect your period. This is a very rare case, though.

How would it affect your cycle?

Excess weight causes imbalances of hormones. With gastric sleeve surgery, and therefore a major weight loss, hormones in your body will balance. Among other hormones, sleeve gastrectomy has a massive impact on sex hormones, such as progesterone and estrogen, and they all strongly affect your periods.  

Progesterone and estrogen – these two of your hormones control the inner lining of the uterus. Estrogen builds it up and progesterone stabilizes it.

If you have excess weight, it results in an increase in the level of estrogen. The reason is that your fat tissue converts steroid hormones into a form of estrogen. Losing weight helps to normalize your hormone levels, which reduces your risks of estrogen buildup.

Therefore gastric sleeve surgery affects the menstrual cycle by improving the regulation of sex hormones, especially estrogen.

How long will my period last?

The length of your period is an individual matter. The minimum duration is usually 3 days and 5 days on average. After sleeve gastrectomy, your periods will get more regular if you had issues with your menstruation before. If it lasts longer than 7 days it is considered to be heavy bleeding (aka menorrhagia). (3) If the bleeding continues or does not stop, you should immediately see your doctor.

How should my period flow be like?

A typical amount of menstrual blood loss during every period is between 5 to 80 ml. Remember that birth control methods may affect the heaviness of your period. Losing over 80 ml of blood per period is described as abnormal and too heavy menstrual bleeding. You can understand that your periods are too heavy when you use more than six maxi-size pads or tampons a day.

There are a few factors that affect the flow of your period. Among them, we can mention your age, weight, medications you regularly use, or stress level. Gastric sleeve surgery might affect your period flow. Your first period after the operation can still be a heavy flow. However, with time it will most probably become lighter. You will start losing the typical amount of menstrual blood every upcoming month.

Will my period be painful?

You may also wonder about a very important thing, which is your period pain after the surgery. The good news is that if you didn’t experience major cramps before your operation, nothing will change in the long term. Even the better news is that, if you did, your cramps will most probably be getting lighter within the upcoming weeks and months. As your cycle changes after the surgery, your menstrual cramps will decrease due to hormonal balance. More regular periods with a lighter flow can affect you in a positive way, causing you less pain.

The first period after the gastric sleeve, however, may cause you some pain. Remember that all the hormonal changes are a bit of a shock for your body and you need to give it the required time to heal and your hormones to balance. For some time after the surgery, you are unable to get sufficient nutrition, which affects your dietary deficiencies. That’s why it’s so important to take prescribed supplements and multivitamins. Also, if you get your period soon after your surgery, you may possibly be facing gas pain. Period pain combined with gas pain might make you feel twisted. All this can make your first period after gastric sleeve, somehow uncomfortable and painful. (2)

Typical cramps usually begin a day or two days before your period and reach their peak around 24 hours after your period begins. They typically last for two to three days.

What can I use if I'm having painful period cramps?

There are a few things you can do if you suffer from painful period cramps. First of all, you can go with nonprescription medications. Before taking any, always remember to consult your doctor.

After the surgery, you will most probably get a short-acting, injectable blood thinner to prevent blood clots. However, it’s better if you don’t take aspirin or aspirin-containing products for one week after your surgery other than the ones your doctor prescribed. Also, do not take non-steroidal anti-inflammatories for one month after your operation.

A non-opioid painkiller generally prescribed after gastric sleeve surgery is acetaminophen/Tylenol. You need to remember though, that acetaminophen in large doses can be the cause of liver damage, so keep in mind to follow the prescription your doctor gave you. Non-opioid medications are generally chosen when dealing with mild to moderate pain.

if you need more informations, you can check our article on medications to avoid after a gastric sleeve.

What else can I do to ease my pain?

You can take some standard medications, but you may also try several home remedies and exercises that will help you reduce your period pain. Here are seven things that you might do to ease your pain naturally for the first period after gastric sleeve:

  1. When you stay active you reduce your pain. You should be careful though for some weeks after your surgery and start only with light exercises, like daily walks. In 2-4 weeks following your surgery, you can introduce yourself to yoga.
  2. Putting heating pads or hot water bottles under your feet might be useful. You can also try taking a warm bath or having a hot shower.
  3. You may do a massage with light, circular moves around your lower abdomen. This is going to help you manage your stress with relaxation techniques.
  4. If you didn’t want to take protein shakes on your post-op diet, you may face vitamin deficiencies. To prevent this, include some vitamins and mineral supplements in your diet: omega-3, magnesium, and vitamins B1 and B6. This way you will boost your immune system and your period pain will decrease.
  5. There is also a study showing that drinking green tea decreases menstrual cramps, so you may also try that. Green tea contains lots of healthy antioxidants, which have anti-inflammatory properties and make your body relax. (4) Drinking green tea after robotic or laparoscopic gastrectomy is safe as long as you start consuming it a month after.
  6. Food that decreases inflammation in the body can help you overcome your menstrual cramps. Both vegetarian and plant-based foods may have beneficial effects: fruits, vegetables, whole grains, legumes, nuts, and seeds. (5) These suggestions can work for you if you are in a suitable dietary stage. 

As you can see, gastric sleeve surgery may actually affect your menstruation positively if you suffered from hormonal disorders and difficult periods before. So, if you previously had long and intense monthly cycles, the good news is – your menstruation can become less painful, shorter, and lighter! If you, on the other hand, didn’t face heavy, irregular period problems, your cycles are expected to remain the same.


(1) Teitelman M, Grotegut CA, Williams NN, Lewis JD. The impact of bariatric surgery on menstrual patterns. Obes Surg. 2006 Nov;16(11):1457-63. doi: 10.1381/096089206778870148. PMID: 17132411.

(2) Barber TM, Hanson P, Weickert MO, Franks S. Obesity and Polycystic Ovary Syndrome: Implications for Pathogenesis and Novel Management Strategies. Clin Med Insights Reprod Health. 2019 Sep 9;13:1179558119874042. doi: 10.1177/1179558119874042. PMID: 31523137; PMCID: PMC6734597.

(3) Duckitt K, Collins S. Menorrhagia. BMJ Clin Evid. 2012 Jan 18;2012:0805. PMID: 22305976; PMCID: PMC3285230.

(4) Zhang X, Zhang R, Chen D, Huang R, Tian Y, Zhang P, Zhang J; Shanghai Birth Cohort. Association of tea drinking and dysmenorrhoea among reproductive-age women in Shanghai, China (2013-2015): a cross-sectional study. BMJ Open. 2019 Apr 8;9(4):e026643. doi: 10.1136/bmjopen-2018-026643. PMID: 30962237; PMCID: PMC6500245.

(5) Turner-McGrievy GM, Wirth MD, Shivappa N, et al. Randomization to plant-based dietary approaches leads to larger short-term improvements in Dietary Inflammatory Index scores and macronutrient intake compared to diets that contain meat. Nutr Res. 2015;35:97-106.

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