Dilation & Curettage (D&C)

What this procedure is

Dilation and curettage, often called a D&C, is a minor surgical procedure used to remove tissue from the inside of the uterus. The uterus is the pear-shaped organ where a baby grows during pregnancy.

The name of the procedure explains the two steps involved:

• Dilation: Your clinician gently widens the cervix, which is the narrow lower part of the uterus that opens into the vagina.
• Curettage: The clinician uses a thin instrument or a gentle suction device to remove a small amount of tissue from the uterine lining.

The procedure is typically short and is performed while you are under anesthesia to ensure you are comfortable and relaxed.

What it treats or fixes

A D&C can be used to either diagnose a problem or treat a known condition. Your clinician may recommend this procedure for several reasons, including:

• Investigating unusual bleeding: This may include very heavy menstrual periods, bleeding between periods, or bleeding that occurs after menopause.
• Checking for health concerns: A D&C allows your clinician to collect a tissue sample to look for polyps, hormonal imbalances, or abnormal cells.
• Post-pregnancy care: If a miscarriage occurs or if tissue remains in the uterus after childbirth, a D&C may be used to clear the lining. This helps prevent heavy bleeding or the risk of infection.

How common it is & where it's done

The D&C is a very common and routine procedure. It is usually performed in a hospital or an outpatient surgery center. Because it is a minor surgery, most patients are able to go home the same day once the anesthesia wears off.

Depending on your specific health needs, your clinician might perform the procedure in their office or a specialized clinic. Your care team will help you understand where the procedure will take place and what to expect during your brief stay.

Recovery: What to Expect

After a D&C, you will usually spend a short time in a recovery area while the anesthesia (medicine to prevent pain) wears off. Most people can go home the same day. It is common to feel some mild cramping or have light spotting for a few days. Your clinician may suggest over-the-counter pain relief to help you stay comfortable.

You can often return to your normal daily activities within a day or two. To help your body heal, your clinician may advise you to avoid using tampons or having intercourse for a short period. Be sure to follow the specific instructions provided by your healthcare team.

Risks & Possible Complications

A D&C is a common and generally safe procedure. While complications are rare, your clinician will discuss them with you beforehand. These may include infection, heavy bleeding, or a small tear in the wall of the uterus (womb). In very rare cases, scar tissue may form inside the uterus.

It is important to monitor how you feel during your recovery. You should contact your clinician if you experience any of the following:

• Heavy bleeding that soaks through a pad quickly.
• A fever or chills.
• Severe abdominal pain that does not go away with medicine.
• Discharge from the vagina that has a strong or unpleasant odor.

Outcomes & Long-Term Results

The main goal of a D&C is often to diagnose a condition or treat heavy bleeding. If tissue was removed during the procedure, it is usually sent to a lab for testing. Your clinician will schedule a follow-up appointment to discuss these results and plan any next steps for your care.

Your menstrual cycle (period) may be slightly different for the first month after the procedure. Your period might arrive earlier or later than usual, but it typically returns to its normal pattern quickly. Most people do not experience long-term changes to their health or fertility from a D&C.

Emotional Support & Reassurance

It is completely normal to feel a range of emotions before and after a D&C. Whether the procedure was planned or unexpected, your healthcare team is there to support you. Do not hesitate to ask questions or share your concerns with your clinician.

Taking time to rest and being kind to yourself is an important part of the healing process. If you find yourself feeling overwhelmed, reaching out to a trusted friend, family member, or a professional counselor can provide extra comfort and peace of mind.

Why doctors recommend it

A clinician may recommend a D&C to find the cause of unusual symptoms or to treat certain conditions. This procedure involves dilation (widening the opening of the uterus) and curettage (removing tissue from the uterine lining). It is often used if you have very heavy periods, bleeding between periods, or bleeding after menopause.

Your doctor might also suggest this procedure to look for:

• Polyps: Small, usually non-cancerous growths in the uterine lining.
• Fibroids: Benign (non-cancerous) tumors that grow in the wall of the uterus.
• Hormonal imbalances: Changes in the body that cause the uterine lining to grow too thick.
• Abnormal cells: Checking for signs of uterine cancer or other concerns.

In some cases, a D&C is recommended if a simple office biopsy did not provide enough information to explain your symptoms.

Urgent vs planned treatment

A D&C can be scheduled as a planned procedure or performed in more urgent situations. A planned D&C is typically used for diagnosis, such as when a clinician needs to sample the uterine lining to investigate long-term bleeding issues.

Urgent treatment may be necessary in the following situations:

• After a miscarriage: If some tissue remains in the uterus after a pregnancy ends, a D&C may be performed to remove it. This helps prevent heavy bleeding or a serious infection.
• Severe bleeding: If a person is experiencing dangerously heavy uterine bleeding, a clinician may use a D&C to stop the blood loss quickly.
• Retained placenta: After childbirth, a D&C may be used to remove pieces of the placenta that did not come out on their own.

Goals of treatment

The primary goal of a D&C is often to get a clear answer about what is happening inside the uterus. By removing a sample of the lining, your care team can send it to a lab to check for abnormal cells. This helps your clinician decide on the best next steps for your care.

Another goal is to provide relief from physical symptoms. For example, removing polyps or clearing the uterine lining can often reduce heavy bleeding and discomfort. Success means that the clinician has either gathered the necessary information for a diagnosis or has cleared the uterus to allow it to heal properly and safely.

Who may benefit

A D&C is a common procedure that helps your clinician learn more about your health or treat specific issues. It involves dilation (widening the opening of the uterus) and curettage (removing a small amount of tissue from the uterine lining). You might benefit from this procedure if you have heavy or irregular bleeding that hasn't improved with other treatments. It is also used to check for abnormal cells in the endometrium (the lining of the uterus), especially if you have bleeding after menopause.

In some cases, a D&C is used to clear the uterus after a miscarriage or birth. This helps prevent heavy bleeding or infection by ensuring no tissue is left behind. Your clinician may also perform a D&C alongside a hysteroscopy, where they use a small camera to look inside the uterus to find the cause of symptoms.

When it may not be the right option

While a D&C is a standard procedure, it may not be the best choice for everyone. For example, if you have an active pelvic infection, your care team may wait until the infection is treated before moving forward with the surgery.

Your clinician will also look at your overall health history. If you have certain medical conditions, such as severe heart or lung issues, or if you have a blood clotting disorder, they may suggest alternative treatments or take extra precautions. In many cases, your clinician may try medication first to manage bleeding before recommending a surgical procedure.

Questions to ask your care team

It is helpful to bring a list of questions to your appointment to help you feel more comfortable. Here are a few you might consider:

• Why is a D&C recommended for my specific situation?
• Are there other treatments, like medication, we should try first?
• What type of anesthesia will be used, and how will it make me feel?
• How long will the procedure take, and when can I go home?
• What should I expect during my recovery at home?

In the procedure room

When you enter the procedure room, you will be asked to lie on an exam table in the same position used for a routine pelvic exam. Your feet will be placed in supports called stirrups. This position allows your clinician to reach the area safely and comfortably.

The healthcare provider will gently insert a tool called a speculum into the vagina. This holds the walls of the vagina apart so they can clearly see the cervix, which is the narrow opening at the bottom of the uterus.

High-level steps

The procedure involves two main steps: dilation and curettage. First, the clinician performs dilation by slowly widening the opening of the cervix. This is often done using a series of smooth, thin rods that gradually increase in size. In some cases, medication may be used beforehand to help the cervix soften and open.

Next is curettage. The clinician uses a small, spoon-shaped instrument called a curette or a gentle suction device to remove a thin layer of the uterine lining. This tissue is often sent to a laboratory for testing to help your clinician understand the cause of any symptoms you may have been experiencing.

In some instances, your clinician may place a small piece of gauze, known as packing, inside the cervix to help manage bleeding. This is a temporary step, and the packing is typically removed before you are discharged.

Anesthesia and pain control

Your care team will use anesthesia to make sure you are comfortable. The type used depends on your health history and the reason for the procedure. You may receive local anesthesia to numb only the cervix, or regional anesthesia (such as an epidural) to numb you from the waist down.

In other cases, general anesthesia may be used so that you are in a deep sleep throughout the process. If you are awake, you might feel some pressure or mild tugging, but the numbing medication helps prevent sharp pain. Your clinician may also suggest over-the-counter pain relief for any mild cramping that occurs afterward.

Monitoring and safety steps

Your safety is the top priority during the procedure. A nurse or technician will monitor your vital signs, including your heart rate, blood pressure, and oxygen levels, using small sensors placed on your skin. This ensures your body is responding well to the anesthesia.

Before the procedure begins, the clinician usually performs a physical exam of the pelvic area. This helps them confirm the size and position of your uterus to ensure the instruments are used with precision and care.

Immediately after the procedure

After the D&C is finished, you will be moved to a recovery area where you can rest. Nurses will continue to check your heart rate and monitor you for any heavy bleeding. Most patients stay in recovery for an hour or two until the anesthesia wears off and they are alert enough to go home.

It is normal to feel some mild cramping or lower back soreness, similar to a menstrual period. You may also have light spotting or bleeding for a few days. Your care team will provide you with a sanitary pad and instructions on how to care for yourself at home.

Typical procedure length

The D&C procedure itself is relatively short, typically lasting between 10 and 15 minutes. While the actual steps are quick, you should plan to be at the hospital or surgical center for several hours.

This extra time allows for the necessary preparation before the procedure and a safe period of observation afterward. Your clinician will let you know exactly what time to arrive and when you can expect to have a friend or family member drive you home.

Common approaches (open vs minimally invasive)

A Dilation and Curettage (D&C) is considered a minor surgical procedure. It is not an "open" surgery, meaning it does not require any cuts (incisions) on the outside of your body. Instead, the doctor reaches the uterus through the vagina and cervix. Because there are no external incisions, recovery is generally faster than with major abdominal surgery.

Your clinician may use different tools depending on why the procedure is being done:

• Traditional D&C: The doctor uses a spoon-shaped instrument called a curette to gently scrape the lining of the uterus.
• Suction D&C: A small tube is used to suction out tissue. This is often used when clearing the uterus after a miscarriage.
• With Hysteroscopy: Often, a thin, lighted tube with a camera (hysteroscope) is inserted along with the other instruments. This allows the doctor to see the inside of the uterus clearly on a screen while they work.

Partial vs total

The terms "partial" and "total" are not typically used to describe a D&C in the same way they are used for organ removal. However, the amount of tissue removed depends on the goal of the procedure.

• Diagnostic (Sampling): If the goal is to find the cause of abnormal bleeding or check for cells that might be cancer, the doctor may only remove a small sample of the uterine lining for testing.
• Therapeutic (Treatment): If the goal is to treat a condition, such as heavy bleeding or polyps, the doctor may remove the entire lining of the uterus or specific growths. This is also done to clear tissue remaining after a miscarriage to prevent infection.

Note: Not always applicable. In some cases, simply removing the lining does not cure the underlying issue, and further treatment may be discussed.

Revision or repeat procedures

Most patients only need one D&C to address a specific issue. However, there are situations where a repeat procedure might be considered. If a D&C was performed to diagnose a problem, and symptoms like heavy bleeding return later, your clinician might recommend repeating the procedure or trying a different approach.

In rare cases following a miscarriage, if not all tissue was successfully removed during the first procedure, a revision (repeat) D&C may be necessary to prevent infection and ensure the uterus is clear.

Tests and imaging that may be done

Your healthcare provider will explain the procedure to you and ask about your medical history. During this time, you will likely be asked to sign a consent form that gives your permission to perform the D&C.

It is important to tell your provider if you are pregnant or suspect that you might be pregnant. Based on your specific medical condition, your clinician may request other specific preparations or checks to ensure your safety.

Medication adjustments

Your care team needs to know about any medicines you are currently taking. This includes prescription drugs, over-the-counter medicines, and herbal supplements. You should also tell your provider if you have a history of bleeding disorders.

Be sure to notify your clinician if you are taking:

• Anticoagulants (blood-thinning medicines)
• Aspirin
• Other medicines that affect blood clotting

Only stop medicines if your clinician instructs you. They will let you know if it is necessary to stop taking these drugs before the procedure. Additionally, tell your provider if you are sensitive or allergic to any medicines, latex, tape, iodine, or anesthesia.

Day-before and day-of instructions

Your provider will give you specific instructions to follow. Common preparations often include:

• Fasting: You may be asked not to eat or drink for 8 hours before the procedure, generally starting after midnight.
• Transportation: You will need to arrange for someone to drive you home after the procedure. You cannot drive yourself because of the anesthesia or sedatives used.
• Relaxation: You may receive a sedative before the procedure starts to help you relax.

General surgical risks

As with any surgical procedure, there are some general risks involved. Complications are possible, though your healthcare team takes steps to keep you safe. General risks may include a reaction to anesthesia (the medication used to block pain or help you sleep).

Other general risks include heavy bleeding or infection after the procedure. Your specific risks may vary depending on your overall health and medical condition.

Procedure-specific complications

In addition to general risks, there are a few complications specific to a D&C. These are not guaranteed to happen, but it is helpful to be aware of them. Possible issues include:

• Perforation of the uterine wall: This occurs if a surgical instrument accidentally makes a hole in the uterus.
• Damage to the cervix: The opening to the uterus (the cervix) can sometimes be injured during dilation.
• Scar tissue: In rare cases, scar tissue may form on the wall of the uterus. This condition is known as Asherman syndrome.

How complications are treated

Your clinician will review your medical history to lower your risks before surgery. Certain conditions, such as an existing pelvic infection or a blood clotting disorder, may interfere with the procedure, so your care team will discuss these with you in advance.

After the procedure, monitoring your recovery is the best way to manage potential problems. You should notify your healthcare provider immediately if you experience fever, foul-smelling drainage, severe abdominal pain, or heavy bleeding. Reporting these signs early helps your doctor treat any complications quickly.

Pain control medicines

Your clinician will tailor pain management to your specific needs. During the D&C, you may receive anesthesia, which is medicine that prevents pain during a medical procedure. This may include local anesthesia to numb the cervix, regional anesthesia to numb a larger area, or general anesthesia to put you to sleep.

After the procedure, it is common to feel some mild cramping. Your healthcare provider may suggest over-the-counter pain relievers to help you stay comfortable. It is important to tell your care team if you have any known allergies to pain medications before the procedure begins.

Antibiotics

Your healthcare provider will provide specific instructions based on your health history and your particular situation. In some cases, clinicians may use medications to help prevent infection. Sharing your full medical history and any drug allergies with your team helps them choose the right approach for you.

If you are prescribed any medicine to prevent infection, your clinician will likely advise you to take it exactly as directed. Following these instructions carefully helps support a healthy recovery.

Blood thinners and clot prevention

Before your D&C, your clinician will ask about all the medications you take. This includes anticoagulants (blood thinners), aspirin, or any other medicines that affect how your blood clots. These are important to discuss because they can increase the risk of bleeding during or after the procedure.

Your provider may ask you to stop taking these medicines for a short time before the D&C. They will give you a specific plan for when to stop and when it is safe to start them again. Always follow your clinician's guidance regarding these medications to ensure your safety.

Emergency warning signs

Although complications are not common, it is important to watch for signs that you need immediate medical attention. Your healthcare provider will give you specific instructions on who to contact if you feel very sick.

Seek help right away if you experience:

• Severe abdominal pain: Pain in your belly that is very strong or does not get better with pain medication.
• Heavy bleeding: Bleeding that is much heavier than a normal period or soaks through pads quickly.

Call your surgeon or clinic if…

Contact your clinician if you notice new symptoms that could be signs of an infection. Catching these signs early helps ensure a smooth recovery.

Notify your healthcare provider if you have:

• Fever or chills: A high temperature or shaking chills.
• Unusual drainage: Fluid coming from the vagina that has a foul or bad smell.

Expected vs concerning symptoms

Knowing what is normal helps you stay calm during recovery. Most people have some mild side effects as the body heals.

Expected symptoms:

• Cramping: You may feel cramping in your abdomen, similar to menstrual cramps.
• Light spotting: It is common to have light bleeding or spotting for a few days.

Concerning symptoms:

While mild discomfort is normal, pain should not be severe. If your cramping becomes unmanageable or if spotting turns into heavy bleeding, contact your provider.

Non-surgical treatments

In many cases, your clinician may suggest trying medication before a D&C. Hormonal treatments, such as progestin or estrogen, are common options. These medications can help regulate the uterine lining (the tissue inside the womb) and may reduce or stop abnormal bleeding.

Other non-surgical approaches might include medications that help the body pass tissue naturally. These options allow you to avoid a procedure while still addressing the underlying health concern. Your clinician will help you decide if medication is a safe first step based on your symptoms.

Watchful waiting

Watchful waiting means your healthcare provider monitors your condition closely without starting a specific treatment right away. This is often an option if your symptoms are mild or if your body is already starting to resolve a situation, such as a miscarriage, on its own.

During this time, your clinician will likely check in with you frequently. They want to ensure that your body is healing safely and that you do not develop signs of infection or excessive blood loss. If the body does not finish the process naturally, you may then discuss other treatments.

When surgery becomes the best option

While non-surgical paths are often preferred, a D&C may become the best choice in certain situations. Your clinician might recommend the procedure if:

• Heavy bleeding: If bleeding is very heavy or does not stop with medication, a D&C can help provide quick relief and prevent further blood loss.
• Incomplete process: If the body does not fully clear the uterine lining after a miscarriage or birth, a D&C may be needed to prevent infection or scarring.
• Diagnostic needs: If your provider needs a clear tissue sample to check for conditions like polyps (small growths) or cancer, a D&C allows them to collect enough tissue for an accurate lab test.
• Failed alternatives: If medications or watchful waiting do not resolve the issue, surgery is often the next step to ensure your long-term health and safety.

Hospital services that commonly perform this surgery

A D&C is a common procedure that is usually done on an outpatient basis, meaning you will likely go home the same day. It is often performed in a hospital's outpatient surgery department or a specialized surgery center.

In some cases, your clinician may perform the procedure in a women's health clinic or their own office. The location often depends on the equipment needed and the type of anesthesia (medicine used to prevent pain) required for your specific needs.

Patient resources and support services

Most facilities provide pre-surgical coordinators. These staff members help you understand what to do before surgery, such as when to stop eating or drinking. You may also have a consultation with an anesthesia provider to discuss how you will be kept comfortable during the procedure.

After the procedure, you will receive recovery support. This includes a nurse who monitors you while you wake up and provides written instructions for your care at home. If tissue was removed for testing, the hospital's laboratory will examine the samples and send the results to your clinician.

Many hospitals also offer patient advocates or financial counselors. These resources can help you navigate insurance questions or find support if you have concerns about the procedure or the costs involved.

Questions for choosing where to have surgery

Choosing a facility where you feel comfortable is an important part of your care. You may want to ask your clinician these questions when deciding on a location:

• Is this facility covered by my health insurance?
• Will the procedure take place in a hospital or an outpatient center?
• What types of anesthesia (sedation or numbing medicine) are offered at this site?
• How long will I need to stay in the recovery area before I am discharged?
• Does the facility have a specialized team for gynecological (women's health) procedures?

Conditions commonly treated by this procedure

A D&C is a common procedure used to diagnose or treat several conditions affecting the uterus. Your clinician may recommend it to help find the cause of unusual bleeding or to clear the uterine lining after certain events.

• Uterine polyps or fibroids: These are non-cancerous growths in the lining or wall of the uterus that can cause discomfort or heavy bleeding.
• Miscarriage: If a pregnancy ends unexpectedly, a D&C may be used to ensure all tissue is removed to prevent infection or heavy bleeding.
• Retained placenta: In some cases, pieces of the placenta may remain in the uterus after childbirth, which a clinician can remove using this procedure.
• Endometrial hyperplasia: This is a condition where the lining of the uterus becomes too thick, which may lead to irregular bleeding.
• Uterine cancer: A D&C can help your care team collect tissue samples to check for the presence of cancerous cells.

Related symptoms people search for

Many people learn about a D&C while looking for answers to specific physical changes. These symptoms do not always mean you need a procedure, but they are common reasons why a clinician might suggest further evaluation.

Symptoms that can be associated with the need for a D&C may include:

• Heavy menstrual bleeding: Periods that last longer than usual or require changing pads or tampons very frequently.
• Bleeding between periods: Noticing spotting or bleeding at times when you do not expect your monthly cycle.
• Postmenopausal bleeding: Any vaginal bleeding that occurs after you have gone through menopause and stopped having regular periods.
• Irregular cycles: Having periods that occur at unpredictable times or vary significantly in length.

If you experience these or other concerns, your clinician can help determine the cause and discuss whether a D&C is an appropriate step for your health.

Evidence overview

Dilation and Curettage, commonly called a D&C, is a standard medical procedure used to diagnose and treat conditions affecting the uterus (womb). Clinicians often recommend it to investigate the cause of abnormal uterine bleeding, to detect conditions like uterine cancer or polyps, or to treat an incomplete miscarriage. It is a well-established practice in gynecology.

The procedure involves two main steps: dilation, which widens the cervix (the opening to the uterus), and curettage, which involves removing tissue from the lining of the uterus. It is typically performed in a hospital or an outpatient clinic.

Safety notes and individualized care

D&C is generally considered a safe procedure, but like all surgeries, it carries some risks. Your healthcare team will take precautions to prevent complications. Potential risks include:

• Heavy bleeding: While some spotting is expected, heavy bleeding is a possible complication.
• Infection: There is a risk of bacteria entering the uterus, though sterile techniques are used to avoid this.
• Injury to the uterus or cervix: In rare cases, the instruments may poke a hole in the uterus (perforation) or injure the cervix.
• Scar tissue: Rarely, scar tissue may form inside the uterus after the procedure (Asherman syndrome).

Your care will be adjusted to your needs, including the type of anesthesia used. You may receive general anesthesia (where you are asleep) or local anesthesia with sedation. During recovery, your clinician may prescribe "pelvic rest," which means avoiding tampons and sexual intercourse for a few days to allow the cervix to close and heal. You should contact your provider if you experience fever, severe cramps, foul-smelling discharge, or heavy bleeding.

Sources used

The information in this section is based on patient education materials from a major academic medical center in the United States.