Post-D&C Surgery: Recovery and Menstrual Cycle Changes

Post-operative condition inquiry after uterine contents curettage?

I was approximately 10 weeks pregnant when the embryo showed signs of degeneration and there was no heartbeat.
I underwent a dilation and curettage (D&C) procedure on July 20.
I continued to experience light bleeding, and after two follow-up visits, I was prescribed uterotonics for two weeks.
The conclusion was that my uterine contractions were inadequate, preventing the expulsion of blood clots, and I needed to undergo another D&C to clear the blood clots from the uterus.
Therefore, I had the second procedure on August 10 (the doctor stated that this procedure was the same as the one on July 20).
During my follow-up appointment one week post-surgery (on August 16), the doctor performed a pelvic examination and found that I was recovering well.
I was not prescribed any medication since I was no longer bleeding, and the doctor said that I could engage in sexual intercourse.
However, it was advised to wait until after one to two menstrual cycles before attempting to conceive again.
On August 18, I had sexual intercourse (with a condom), but on the morning of August 20, I noticed what seemed to be the onset of my period, with some brownish-red discharge.
I would like to know if this situation is normal.
Should I consider my menstrual cycle to start from July 20 or from August 10, counting 4 to 6 weeks afterward?

eager, 20~29 year old female. Ask Date: 2013/08/20

Dr. Dong Yuhong reply Obstetrics and Gynecology

Hello, Dr.
Dong is on leave.
I am Dr.
Tsao Kuo-Tao, the acting director of the obstetrics and gynecology department, responding to your inquiry.
It is normal to experience some bleeding after a dilation and curettage (D&C) procedure.
If there are no issues during your follow-up appointment, you should simply monitor the situation.
The next menstrual period is typically calculated as starting 4 to 6 weeks after August 10.
Wishing you good health.

Reply Date: 2013/08/20

More Info

After undergoing a dilation and curettage (D&C) procedure, it is common for patients to experience various changes in their menstrual cycle and recovery process. In your case, you had two D&C surgeries due to retained products of conception and blood clots, which can complicate the recovery and menstrual cycle normalization.

Firstly, it is important to understand that after a D&C, the body goes through a healing process. The uterus needs time to recover from the procedure, and this can affect your menstrual cycle. Typically, after a D&C, it may take several weeks to a few months for your menstrual cycle to return to its regular pattern. The timing can vary significantly from person to person, depending on individual health factors, hormonal balance, and the extent of the procedure.

In your situation, since the first D&C was performed on July 20 and the second on August 10, it is reasonable to consider that your menstrual cycle may start counting from the second procedure, especially since the first surgery was complicated by retained tissue. The bleeding you experienced on August 20, which you described as brownish with red discharge, could be a sign of your body beginning to shed the uterine lining, which is a normal part of the menstrual cycle. This type of bleeding can occur as the uterus heals and can sometimes be mistaken for a period.

Regarding the timing of your next menstrual cycle, it is generally recommended to wait 4 to 6 weeks after the D&C before expecting your first period. Since you had a second D&C on August 10, you might expect your next menstrual cycle to start around late September to early October, depending on how your body responds to the procedures and your individual cycle length prior to the pregnancy.

It is also important to note that after a D&C, some women may experience irregularities in their menstrual cycle, such as lighter or heavier periods, changes in cycle length, or spotting between periods. These changes are usually temporary as the body readjusts. If you continue to have concerns about your menstrual cycle or if the bleeding becomes heavy or is accompanied by severe pain, it is advisable to follow up with your healthcare provider for further evaluation.

In summary, the bleeding you experienced after your second D&C could be a normal part of your recovery process, and it is likely that your menstrual cycle will start counting from the second procedure. However, every individual is different, and monitoring your symptoms and communicating with your healthcare provider is crucial for ensuring a smooth recovery. If you have any further questions or concerns, do not hesitate to reach out to your doctor for personalized advice and support.

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