A Dilation and Curettage (D&C) is a common surgical procedure to remove tissue from the inside of the uterus. This is achieved by first gently opening the cervix and then using a thin instrument, a curette, to remove the uterine lining or contents. The procedure is performed for various reasons, including diagnosis of abnormal bleeding or clearing the uterus after a miscarriage. Recovery involves managing post-operative symptoms, and the most frequent question concerns the duration of vaginal bleeding. This temporary bleeding is a normal part of the body’s healing process.
The Expected Timeline of Post-Procedure Bleeding
The time it takes for bleeding to stop after a D&C generally falls within a predictable range. While individual experiences vary, post-procedure bleeding and spotting typically last between a few days and two weeks. In some instances, light spotting may persist for up to four weeks as the uterine tissue heals.
The immediate recovery phase (the first 24 to 48 hours) often involves a moderate flow, similar to a regular menstrual period. This initial flow is followed by a noticeable reduction in intensity. Around three to seven days after the procedure, the bleeding usually transitions into light spotting.
This spotting represents the final stage of the body shedding the remnants of the uterine lining and is much lighter than the initial flow. The intensity of bleeding may fluctuate, occasionally increasing slightly with physical activity before settling back down. If bleeding continues beyond two weeks, consult a healthcare provider for follow-up.
Monitoring Flow and Characteristics
Observing the quality and characteristics of the post-procedure flow is important for monitoring recovery. Initially, the discharge may be bright red, but as healing progresses, the color changes. It shifts from red to a pinkish hue, and eventually becomes a dark brown discharge or light spotting.
It is normal to pass small blood clots during the first few days following the D&C. These clots are typically small and represent the body clearing out remaining material from the uterine cavity. The presence of small clots should not cause concern, as they are a temporary feature of the healing process.
A helpful way to monitor blood loss is by assessing the size of any clots passed. Clots smaller than the size of a quarter are considered normal. Passing clots consistently larger than a lemon, however, indicates heavier bleeding that warrants a call to your medical team.
Identifying Symptoms That Require Immediate Medical Attention
While mild bleeding and cramping are expected, certain signs indicate a complication requiring prompt medical intervention. Heavy bleeding is defined by the rate of pad saturation, a measurable indicator of excessive blood loss. Seek immediate care if you are soaking through two or more maxi pads in a single hour for two consecutive hours.
Severe or escalating pain that does not improve with over-the-counter pain medication is a concerning sign. Menstrual-like cramping is normal as the uterus contracts back to its pre-procedure size, but pain that becomes progressively worse or is debilitating can signal an issue.
A temperature of 100.4°F (38°C) or higher should be reported immediately to a healthcare provider. Furthermore, vaginal discharge that develops a foul or unpleasant smell may indicate an infection inside the uterus. These symptoms, when combined with chills or lasting dizziness, require an urgent medical assessment.
Resumption of the Normal Menstrual Cycle
The timing for the return of the normal menstrual cycle is distinct from the immediate post-procedure bleeding. The body needs time for hormone levels to re-establish a typical pattern and for the uterine lining to build back up. Most individuals can expect their first full menstrual period to return approximately four to six weeks after the D&C procedure.
This timeframe can extend up to eight weeks, depending on the reason for the D&C and previous cycle regularity. The first period after the procedure may differ from previous cycles, potentially being either heavier or lighter than usual. A heavier flow is sometimes due to a thicker endometrial lining developed during recovery.
Ovulation, the release of an egg, may resume sooner than the first period, sometimes as early as two weeks after the procedure. This means that fertility can return before the first menstrual cycle is completed. If the period has not returned by eight weeks, consult a healthcare provider to ensure recovery is progressing as expected.