Dilation and curettage

Overview

Dilation and curettage (D&C) is a minor surgical procedure to remove tissue from inside the uterus. The cervix (the opening to the uterus) is gently widened (dilated) and a thin instrument called a curette is used to scrape or suction away the lining. It is done for diagnosis or treatment.

Yes, D&C is a common procedure performed for many reasons, including abnormal uterine bleeding, miscarriage management, or to obtain a sample of tissue for testing.

It is most often done for women of reproductive age, but can also be used for postmenopausal women or in rare cases for teenagers with certain conditions.

Symptoms

Common symptoms

• Heavy or prolonged menstrual bleeding
• Bleeding between periods
• Postmenopausal bleeding
• Tissue remaining after a miscarriage or abortion

Symptoms in children

• D&C is very rarely performed in children. If needed, it may be for severe abnormal bleeding due to hormonal issues or after certain surgeries.

Symptoms in older adults

• In older adults, D&C is often done to investigate the cause of bleeding after menopause, which could be due to polyps, fibroids, or other changes in the uterine lining.

Causes

Main causes

• Abnormal thickening of the uterine lining (endometrial hyperplasia)
• Uterine fibroids or polyps
• Miscarriage or incomplete abortion
• Heavy or irregular bleeding that doesn't respond to medication

Risk factors

• Age over 40
• Obesity
• Hormonal imbalances (e.g., polycystic ovary syndrome)
• Long-term use of oestrogen without progesterone
• History of endometrial polyps or fibroids

When to see a doctor

See a doctor urgently if:

• If you have heavy vaginal bleeding after a D&C that doesn't slow down
• If you have a fever or severe pain after the procedure
• If you notice foul-smelling discharge or feel very unwell

Book a routine appointment if:

• If you have abnormal bleeding that lasts longer than a few cycles
• If you've had a miscarriage and are unsure if tissue remains
• If your healthcare provider recommends a D&C to diagnose a condition

Diagnosis

D&C is often performed as part of a diagnosis. Before the procedure, your healthcare provider will assess your symptoms, do a pelvic exam, and may order an ultrasound or a biopsy of the uterine lining.

Tests that may be done

• Pelvic ultrasound to look at the uterus and ovaries
• Endometrial biopsy (taking a small sample of the lining with a thin tube)
• Hysteroscopy (a tiny camera placed into the uterus to see inside)

What to expect at your appointment

The procedure is usually done under local or general anaesthesia. You will be asked to lie on a table with your legs in stirrups. The doctor will gently dilate your cervix and then use a curette to remove tissue. It takes about 15 minutes and you can go home the same day.

Treatment

Dilation and curettage itself is a treatment. It is used to remove abnormal tissue from the uterus, stop heavy bleeding, or collect a sample for testing. After the procedure, the tissue is sent to a lab to check for any problems.

Self-care at home

• Rest for the rest of the day after the procedure
• Use sanitary pads rather than tampons for the first week to reduce infection risk
• Avoid sexual intercourse, swimming, and using douches for about two weeks
• Take paracetamol or ibuprofen (unless you have a medical reason not to) for mild cramping

Medical treatments

After D&C, your healthcare provider may recommend hormonal medications, such as birth control pills or a progesterone device, to help regulate your cycle and prevent the lining from building up again. These are general treatments and will be discussed with you based on your results.

When is surgery considered?

D&C is considered a minor surgical procedure. In some cases, if more tissue needs to be removed or if polyps or fibroids are present, a hysteroscopy (surgery with a camera) or other surgery may be recommended. Your healthcare provider will explain the options.

Living with this condition

Recovery from D&C is usually quick. Most women feel back to normal within a few days. You may have some spotting and mild cramps, like a period. Follow your doctor's advice about activity and when you can return to work.

Lifestyle tips

• Give yourself time to rest – at least 24 hours after the procedure
• Stay hydrated and eat healthy foods to support healing
• Avoid heavy lifting or strenuous exercise for one week
• Keep a record of your bleeding and any pain, and share it with your provider

Diet and exercise

There are no special dietary restrictions. A balanced diet with plenty of fruits, vegetables, and iron-rich foods (like spinach, lentils, lean meat) can help if you had heavy bleeding. Gentle walking is fine after the first day, but avoid intense workouts for about a week.

Mental health and emotional wellbeing

A D&C can be emotional, especially if it was done after a miscarriage. You may feel sadness, anxiety, or relief. It's normal to have mixed feelings. Give yourself permission to feel whatever comes up, and talk to a trusted friend, family member, or a counsellor.

Prevention

Many conditions that lead to a D&C cannot be prevented, such as miscarriage or hormonal changes. You can reduce your risk of some uterine problems by maintaining a healthy weight, managing conditions like diabetes, and seeing your healthcare provider for regular gynaecological check-ups.

Screening programmes

Regular cervical screening (smear tests) can detect early changes, but D&C is not a screening test. If you have abnormal bleeding, your provider may recommend an ultrasound or biopsy instead of a screening.

Complications

If left untreated

• If the condition that led to the D&C is not addressed, symptoms like bleeding or pain may continue or worsen
• Infection can occur if tissue remains in the uterus after a miscarriage
• Rarely, untreated uterine lining changes can develop into cancer

Long-term outlook

For most women, a D&C is a safe and effective procedure that helps diagnose or treat the problem. Recovery is usually straightforward. If the tissue sample shows any abnormal cells, further treatment is often very successful, especially when caught early. Your healthcare team will guide you through every step.

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