Dilation and Curettage (D&C): Procedure, Recovery & When It’s Needed

What Is Curettage (D&C)?

A dilation and curettage (D&C) is a procedure to remove tissue from the uterine lining, often used to investigate abnormal bleeding, after miscarriage or to diagnose conditions like polyps, fibroids, hyperplasia or uterine cancer. During the procedure, the cervix is gently widened and tissue is removed using a curette, sometimes with suction.

It may be performed on its own or alongside hysteroscopy, which uses a small camera to view the uterus. D&C is usually done under sedation or anaesthesia, and the tissue removed is often sent to a laboratory for examination.

When Is Curettage Needed?

Your doctor may recommend curettage for several reasons. The indication helps determine when and how the procedure is performed.

• Abnormal uterine bleeding: Curettage may be advised if you have very heavy periods, bleeding between periods, bleeding after sex or bleeding after menopause. It allows the doctor to sample the uterine lining to check for conditions such as polyps, hyperplasia or cancer.
• After a miscarriage or abortion: Curettage is commonly used to remove remaining pregnancy tissue after a miscarriage or termination. Clearing this tissue lowers the risk of infection and heavy bleeding and helps the uterus return to normal.
• After childbirth: Sometimes a small part of the placenta remains in the uterus after delivery. Curettage can remove this retained tissue when it is causing ongoing bleeding or concern for infection.
• Suspected abnormal pregnancy or uterine conditions: It may be recommended to remove abnormal pregnancy tissue, such as in a molar pregnancy or to obtain samples if scans show unusual thickening or growths in the uterine lining.

Your gynaecologist will usually consider less invasive options such as medicines or an outpatient endometrial biopsy before recommending dilation and curettage.

What Happens During the Curettage Procedure?

Although details vary between hospitals, the basic steps of the curettage procedure are similar.

• Anaesthesia and Positioning: You will lie on your back with your legs supported. Depending on your case, you may receive local anaesthesia, sedation or general anaesthesia. Your doctor will explain the safest option.
• Examination and Dilation: A speculum is inserted to view the cervix, which is then gently opened with thin instruments to allow a curette or suction tube to enter. Pressure or cramping may be felt, but sharp pain should be minimal.
• Curettage of the Uterine Lining: The doctor removes tissue using a curette, sometimes with suction. In suction curettage, a soft cannula attached to a vacuum device may be used, especially for early pregnancy loss.
• Completion of the Procedure: Removed tissue may be sent for lab analysis. Instruments are withdrawn, and you are moved to recovery. The procedure usually takes 10-20 minutes after anaesthesia.

What Should You Expect After Curettage?

After curettage, you will be monitored in a recovery area until fully awake and stable. Mild drowsiness or light-headedness may occur if you have had sedation or general anaesthesia.

1. Pain and Bleeding

• Mild to moderate cramping, similar to period pain
• Light to moderate vaginal bleeding or spotting for a few days, sometimes up to two weeks
• Pain relief, such as paracetamol or medication advised by your doctor, usually helps. Use sanitary pads until your doctor confirms tampons or menstrual cups are safe.

2. Activity and Self-care

• Avoid driving, alcohol and strenuous activity for 24 hours
• Resume light daily activities within a day or two
• Avoid vaginal intercourse for 1-2 weeks, and swimming or baths until bleeding stops
• Follow all instructions from your clinic or hospital.

3. Periods and Fertility

Your next period may arrive within 4-6 weeks. Most individuals can conceive after curettage, but discuss timing with your doctor if the procedure followed a miscarriage or was for a specific medical condition.

What Are the Risks and Possible Complications of Curettage?

Curettage is generally safe, but carries some risks.

1. Common, usually mild issues:

• Cramping or pelvic discomfort for a few days
• Light to moderate vaginal bleeding or spotting
• Temporary changes in your menstrual cycle

2. Less common risks:

• Infection (endometritis), causing fever, pelvic pain or abnormal discharge
• Heavy bleeding, especially if tissue is retained or there’s a bleeding disorder

3. Rare but serious complications:

• Uterine perforation, which may need treatment
• Cervical injury
• Intrauterine adhesions (Asherman syndrome), which can affect periods or fertility

Asherman syndrome can sometimes be treated with hysteroscopic surgery and hormonal support. Doctors weigh these risks against the benefits before recommending curettage.

When Should You Contact Your Doctor After Curettage?

Most people recover without problems, but contact your doctor or seek emergency care if you have:

• Very heavy bleeding (soaking a pad in an hour or passing large clots)
• Fever or chills
• Increasing or severe abdominal or pelvic pain not relieved by medication
• Foul-smelling vaginal discharge
• Dizziness, fainting or feeling unwell

Also, speak to your doctor if your periods do not return within a few months. A follow-up visit may be advised to review lab results and discuss any further care.

Conclusion

Curettage can feel daunting, but understanding why it is needed and what to expect can make the process far less overwhelming. More than anything, it empowers you to recognise what is normal during recovery and when to seek help. If you are considering or preparing for the procedure, remember that you are entitled to clear explanations and reassurance at every step. Ask questions, share concerns and trust your instincts. Feeling informed and supported is just as important as the procedure itself.