A hysteroscopy is a minimally invasive medical procedure used to examine the inside of the uterus using a thin, lighted tube called a hysteroscope. This instrument is inserted through the vagina and cervix, allowing a doctor to visualize the uterine cavity. The procedure serves both diagnostic and treatment purposes, such as identifying abnormal bleeding or removing structural issues like polyps or fibroids. Some vaginal bleeding is a normal and expected part of the healing process following this internal examination and potential manipulation of the uterine lining.
Typical Post-Procedure Bleeding Timeline
Bleeding following a hysteroscopy typically begins as a light flow or spotting right after the procedure is completed. This initial discharge is often mixed with the fluid used to expand the uterus during the examination, giving it a watery, blood-tinged appearance. For most patients, this light bleeding will persist for a period ranging from a few days up to two weeks.
The color of the discharge often changes, transitioning from bright red to pink, brown, or dark as the volume decreases. This indicates the blood is older and the surgical site is healing. Spotting is often intermittent, meaning it may stop entirely for a day or two before briefly returning. While bleeding typically lasts less than two weeks, some individuals may experience light spotting or dark discharge for up to three weeks.
Factors Influencing Bleeding Intensity and Length
The specific nature of the hysteroscopy performed is the primary factor determining the intensity and duration of post-procedure bleeding. A diagnostic hysteroscopy, which is solely an examination to look inside the uterus or take a small tissue sample, usually results in minimal bleeding that resolves within a few days. Since this type involves little surgical manipulation, the recovery period is shorter.
Conversely, an operative hysteroscopy, which involves surgical treatment, causes more significant bleeding and a longer recovery timeline. Procedures like the removal of uterine fibroids (myomectomy) or polyps (polypectomy) require the cutting and cauterization of tissue, leading to a heavier flow.
Endometrial ablation, the intentional destruction of the uterine lining to control heavy bleeding, can result in discharge that may continue for up to six weeks as the treated tissue sheds. Patient health factors, such as the use of blood thinners, can also increase the overall volume and length of time an individual bleeds.
Distinguishing Normal Bleeding from Concerning Symptoms
While some bleeding is anticipated, it is important to monitor the amount to ensure it remains within a safe range. Bleeding is considered abnormally heavy if it soaks through one sanitary pad completely in an hour, and this saturation rate continues for several consecutive hours. The passage of large blood clots is also a measure of excessive bleeding, specifically if they are the size of a quarter or larger.
Patients should seek immediate medical attention if their bleeding increases in volume rather than decreasing over time, especially several days after the procedure. Other serious symptoms indicating a potential complication include a persistent or high fever, typically 100.4°F or higher. Severe abdominal pain not relieved by over-the-counter medication, or vaginal discharge with a foul smell, should also be promptly reported, as these can signal an infection.
Managing Other Aspects of Post-Hysteroscopy Recovery
Beyond managing the expected bleeding, patients will typically experience mild, menstrual-like cramping following the procedure. This discomfort occurs as the uterus contracts and generally subsides within one to three days. Over-the-counter pain relievers, such as acetaminophen or ibuprofen, are usually effective in managing this mild post-procedure pain.
To prevent infection, specific restrictions are placed on internal vaginal activities. Patients must use only sanitary pads for any bleeding or discharge and avoid using tampons until their next period. It is also advised to avoid sexual intercourse, douching, and soaking in bathtubs or pools for at least one week, or until all vaginal bleeding has completely stopped.