When Will My Period Return After Uterine and Cervical Scraping?

After a dilation and curettage (D&C) and cervical scraping, when can one expect their menstrual period to return?

Hello Dr.
Tsao: Last year, I underwent chemotherapy, during which my surgeon administered Leuprolide to protect my ovaries.
My last chemotherapy and Leuprolide injection were on March 16 of this year.
My menstruation stopped after starting chemotherapy in October of last year.
However, I had my period on August 14 this year, and my Pap smear results showed AGC (Atypical Glandular Cells).
My doctor scheduled a cervical and endometrial curettage on September 6.
The postoperative pathology report stated: "Uterus endometrium and endocervix labeled as 'cervix' curetting mild inflammation.
Uterus endometrium curetting polypoid proliferative endometrium.
Specimen A is mainly composed of endometrial tissue admixed with a small portion of endocervical tissue with mild inflammation.
Specimen B shows polypoid proliferative endometrium.
Focal tiny foci demonstrating secretory features are seen.
No evidence of malignancy is observed." The doctor informed me of the inflammation and stated that there were no precancerous lesions.
The uterus appeared healthy on the transvaginal ultrasound, and I was advised to have another Pap smear and transvaginal ultrasound in six months.
The doctor did not mention when my next period would be, but I read online that a uterine curettage is equivalent to the onset of menstruation, so I expected my next period to be in early October.
A) However, I got my period on September 19.
Is this normal? B) My pathology report indicated inflammation, but the doctor did not prescribe any medication (I am not the type that requires Tamoxifen).
What should I pay attention to in order to prevent inflammation in the uterus?

Peipei, 30~39 year old female. Ask Date: 2023/09/18

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, it is normal to have your menstrual period about a month after surgery.
You experienced some bleeding on September 19, which should be monitored.
As for inflammation, you may consider taking some anti-inflammatory medication.
Wishing you good health.

Reply Date: 2023/09/18

More Info

After undergoing uterine and cervical scraping, it is common to have questions regarding the return of menstruation and the implications of the procedure on your reproductive health. Based on your situation, let's address your concerns in detail.

A) Regarding the timing of your next period after the scraping procedure, it is indeed possible for menstruation to resume sooner than expected. In your case, experiencing your period on September 19, just a short time after the scraping on September 6, can be considered normal. The scraping procedure can sometimes stimulate the endometrium (the lining of the uterus), leading to a quicker return of menstrual bleeding. The timing of menstruation can vary significantly among individuals, especially after surgical procedures, hormonal treatments, or chemotherapy, which can all impact the menstrual cycle. Given that you had a period in August after a long hiatus due to chemotherapy, your body may be adjusting to the changes, and the return of your period could be a sign of your reproductive system beginning to normalize.

B) As for the pathology report indicating mild inflammation without any precancerous changes, it is reassuring that there is no evidence of malignancy. However, inflammation can still be a concern, and while your doctor did not prescribe medication, it is essential to monitor your symptoms. To help prevent further inflammation, consider the following recommendations:
1. Follow-Up Care: Keep up with your scheduled follow-ups, including the Pap smear and ultrasound in six months. This will help monitor your uterine health and any potential changes.

2. Healthy Lifestyle: Maintain a balanced diet rich in fruits, vegetables, whole grains, and lean proteins. Staying hydrated and avoiding excessive alcohol and caffeine can also support overall health.

3. Manage Stress: Stress can affect hormonal balance and overall well-being. Engage in stress-reducing activities such as yoga, meditation, or gentle exercise.

4. Avoid Irritants: Be cautious with products that can irritate the vaginal area, such as scented soaps, douches, or harsh cleansers. Opt for gentle, unscented products.

5. Monitor Symptoms: Keep track of any unusual symptoms, such as increased pain, unusual discharge, or prolonged bleeding. If you notice any concerning changes, contact your healthcare provider promptly.

6. Communication with Your Doctor: If you have ongoing concerns about inflammation or any other symptoms, do not hesitate to reach out to your healthcare provider for further evaluation or advice.

In conclusion, while the return of your period shortly after the scraping procedure can be normal, it is essential to continue monitoring your health and maintaining open communication with your healthcare provider. Your body is undergoing significant changes, especially after chemotherapy and surgical interventions, and taking proactive steps can help ensure your reproductive health remains stable.

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