Dilation and curettage (D&C) for bleeding during menopause

Surgery Overview

Dilation and curettage (D&C) is a surgical procedure used to locate and treat the cause of sudden, heavy bleeding. It is done by passing a small instrument called a curette through the vagina into the uterus and scraping the endometrium.

D&C is generally an outpatient procedure. A general anesthetic is usually used, though a local or spinal anesthetic may be used.

What To Expect After Surgery

The recovery period following D&C is short, and most women are able to return to normal activities within 1 to 2 days.

During the recovery period:

• Mild pelvic cramping may occur for a few hours.
• A slight vaginal discharge may occur.
• Intercourse, douching, and the use of tampons are not usually permitted for 2 weeks.
• Your next menstrual period may be early or late.

Why It Is Done

Dilation and curettage (D&C) is used to diagnose and treat bleeding problems. It is used to control sudden, heavy vaginal bleeding that is causing heavy blood loss (hypovolemia) or a low number of red blood cells (anemia). D&C is the quickest way to stop active bleeding in the uterus.

D&C is one method used to get a tissue sample for testing. For example, a post-menopausal woman who has vaginal bleeding is usually tested for signs of endometrial cancer.¹

How Well It Works

• D&C usually temporarily stops heavy menstrual bleeding.
• A biopsy of uterine tissue can be obtained for diagnosis and to eliminate other possible causes of heavy menstrual bleeding.
• Small fibroids may be removed.

Recurrence Sudden, heavy bleeding may stop for a period of time. However, heavy bleeding usually returns following D&C.

Risks

Complications from a D&C are rare but include:

• Infection.
• Puncture (perforation) of the uterine wall.
• Heavy vaginal bleeding (hemorrhage).
• Scarring of the lining of the uterus. This can make it hard to become pregnant. Scarring can also make it hard for the placenta to attach to the inside of the uterus.

What To Think About

Abnormal vaginal bleeding that is not caused by cancer may naturally stop after menopause.

D&C may be needed to diagnose endometrial cancer and to control vaginal bleeding that is causing anemia.

The hospital or surgery centre may send you instructions on how to get ready for your surgery or a nurse may call you with instructions before your surgery.

Right after surgery, you will be taken to a recovery area where nurses will care for and observe you. Usually you will stay in the recovery area for 1 to 4 hours, and then you will go home. In addition to any special instructions from your doctor, your nurse will explain information to help you in your recovery. You will likely go home with a sheet of care instructions including who to contact if a problem arises.

Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.

Author:	Kathe Gallagher, MSW Carrie Henley	Last Updated: February 21, 2007
Medical Review:	Joy Melnikow, MD, MPH - Family Medicine Ross Berkowitz, MD - Obstetrics and Gynecology Andrew Swan, MD, CCFP, FCFP - Family Medicine
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