A Dilation and Curettage, or D&C, is a common procedure where a healthcare provider gently opens the cervix and uses a slender instrument, called a curette, to remove tissue from the uterus. This procedure is performed for various reasons, including removing tissue following a miscarriage or abortion, or to diagnose and treat abnormal uterine bleeding. The physical recovery from a D&C is often quick, but the menstrual cycle is temporarily interrupted, and many people wonder when their period will return.
How the D&C Affects the Menstrual Cycle
The D&C procedure involves removing the endometrium, the functional layer of the uterine lining that sheds during a regular menstrual period. This removal means the uterus must fully regenerate a new endometrial layer before a true menstrual cycle can resume.
Following a D&C, especially after a pregnancy loss, levels of the pregnancy hormone human chorionic gonadotropin (hCG) must drop back to zero. This drop signals the brain that the reproductive cycle should begin again. The body’s hormonal cycle is reset, but the physical regeneration of the uterine lining dictates the timeline for the first period.
The Expected Timeline for Menstrual Return
Most people can expect their first period to return between four and eight weeks following the D&C procedure. This variation is due to the time required for the uterine lining to regenerate and for hormonal signals to re-establish a functional ovulatory cycle. The timing of the first cycle is unpredictable and may not align with the patient’s previous cycle length.
Several factors influence where a person falls within this four-to-eight-week window. If the D&C was performed following a later-stage pregnancy loss, the hormone levels take a longer time to return to pre-pregnancy norms, which can delay the cycle’s return. Conversely, a D&C performed for diagnostic purposes may result in a quicker return to menstruation.
A person’s cycle regularity before the procedure also plays a role in the timing of the period’s return. Those who had irregular periods are more likely to experience a longer or more unpredictable wait for their first post-procedure period. The first cycle typically begins with ovulation, and the time it takes for the ovaries to release an egg varies for each individual.
What to Expect from the First Period
The first period after a D&C can often differ noticeably from previous periods due to the uterine lining rebuilding itself and the hormonal system stabilizing. The flow may be heavier than usual, potentially with more clotting, for the first one or two cycles. This variation is common as the body adjusts and is generally not a cause for concern.
Some people may experience a lighter-than-normal flow, which can sometimes be the result of a very thorough procedure or, in rare cases, a sign of scar tissue development. The duration of the period may also be slightly shorter or longer than a typical cycle. Changes in cramping are also common, with some reporting increased pain and others noting less discomfort.
The first period may also be preceded by a small amount of spotting as the uterine lining prepares to shed. These changes are usually temporary, and the menstrual cycle should generally return to its previous pattern within a couple of months.
When to Contact a Healthcare Provider
While a delayed or different-than-usual period is common after a D&C, certain symptoms warrant immediate contact with a healthcare provider. If a period has not returned by eight to ten weeks after the procedure, medical consultation is necessary to investigate the cause. A prolonged absence of menstruation could rarely indicate the formation of scar tissue inside the uterus.
Signs of potential infection or complication must be addressed promptly. Seek immediate medical attention if you experience:
- A high fever or chills.
- Severe and persistent pain or cramping that does not improve with over-the-counter medication.
- A foul-smelling vaginal discharge.
- Extremely heavy bleeding, such as soaking two or more pads in an hour for several consecutive hours.
The appearance of large blood clots, especially those bigger than a 50-cent coin, should also be reported to a doctor. Any lasting dizziness or lightheadedness indicates a need for professional evaluation.