The nature of menstruation after hysteroscopy - the norm and deviations


Usually, menstrual periods after hysteroscopy with curettage do not practically differ from ordinary menstruations in terms of compliance with the cycle, duration and volume of secretions established during the hormonal formation of a woman's body. The hysteroscopy procedure is prescribed for the study of the uterus, removal of endometrial pathologies, and abortion.

The effect of hysteroscopy on the menstrual cycle

A standard hysteroscopic examination procedure may have some effect on the menstrual cycles in the event of curettage, that is, removal of the surface layer of the endometrium. Scraping is performed to remove polyps, malignant intrauterine neoplasms, as well as during an abortion performed by a woman or by medical indications.

With such an effect, a slight shift in the menstrual cycle is possible for a period equal to the number of days from the last menstrual period to the date of the procedure. That is, menstrual flow will normally begin about a month after hysteroscopy. In general, this is due to the fact that the procedure is performed a minimum time after the end of the menstruation, ideally on the day after the menstruation. Unless, of course, we are not talking about abortion.

Indications for hysteroscopy with scraping

Hysteroscopy is a visual examination of the internal cavity of the uterus with the help of special equipment, which is produced for diagnostic or therapeutic and diagnostic purposes. Diagnosis with the help of a hysteroscope is carried out in the following cases:

  1. Difficulties in the diagnosis of endometrial pathologies.
  2. The impossibility of obtaining a result with ultrasound.
  3. Abundant and prolonged periods, the presence of blood clots in the discharge.

The indications for therapeutic separate diagnostic curettage (RDV) under hysteroscopic control are:

  1. Abundant uterine bleeding occurring between menstruations.
  2. The presence of polyps and pathologies of the endometrium of the uterus.
  3. Suspicion of the presence of malignant tumors in the uterus.
  4. Violations of the menstrual cycle.
  5. Removal of fragments of the placenta after a frozen pregnancy or incomplete spontaneous abortion (miscarriage).


The process of therapeutic and diagnostic curettage of the uterus includes the primary surgical impact in the area of ​​the cervical canal and histological examination of the resulting scraping. After that, if necessary, hysteroscopy is performed with curettage of the uterus to prevent and eliminate the development of various pathologies.

The procedure of scraping hysteroscopy refers to the category of invasive and is accompanied by painful sensations. In this regard, therapeutic and diagnostic curettage is performed under general or local anesthesia (depending on the nature of the surgical intervention).

When performing hysteroscopy, the cervix is ​​dilated, the necessary surgical instruments are inserted into the organ cavity, and the required surgical intervention is performed. The results of the procedure are monitored using a hysteroscope. If necessary, scraping is repeated. Materials obtained after diagnostic curettage are transferred to the morphological study.

The nature of menstruation after hysteroscopy

Deviations of the duration of the menstrual cycle after cleaning, in particular, its reduction or slight increase, are not a sign of serious complications and depend only on the individual reaction of the woman’s body to the procedure. Often, the first menstruation after curettage can last longer than usual.

During this period, it is necessary to pay special attention to the nature of the discharge, to the presence of pain, as well as to the general condition of the woman’s body.

As a rule, after diagnostic curettage, there is no violation of the hormonal background and, consequently, the menstrual cycle. Although some deviations still occur due to certain individual characteristics of the organism, general health, the number of births, abortions, past diseases of the genitourinary system and some other parameters.

The main pathologies of the posthysteroscopic period: too abundant or too scanty menstruation. In both cases, an urgent examination of the attending gynecologist is required to establish the exact cause of the pathology that has arisen and to eliminate it. Too much menstruation, requiring a gasket change every 2.5 to 3 hours, can lead to a large blood loss, a drop in hemoglobin level, a decrease in blood pressure and a general weakening of the body.

Usually scanty periods after curettage are accompanied by a decrease in general well-being, an increase in temperature, and pain in the area of ​​the reproductive organs. The discharge in this case has a dark color and an unpleasant smell. This suggests that an infectious-inflammatory process has begun in the uterus, such as endometriosis, which occurs in the case of an abortion that has not been properly performed.

Dangerous effects of scraping

Hysteroscopic curettage is a surgical procedure, especially when forcibly terminating a pregnancy or removing the effects of a miscarriage. Therefore, there may be various kinds of side effects, often unsafe for the female body.

If particles of the fetus or membranes remain in the uterus, this causes inflammation and requires immediate treatment. Otherwise, the infection may penetrate deeper into the uterine lining or spread to nearby organs. In this situation, the woman is primarily given a blood test to determine human chorionic gonadotropin (hCG). The positive result of this laboratory study confirms the need for re-curettage of the uterus to remove residual fetal tissue.

The main problem that occurs after hysteroscopy is damage to the walls of the main reproductive organ - the uterus. Depending on the nature of the damage, various kinds of inflammation occur due to infection. Very often, hysteroscopy causes female infertility. Therefore, practicing gynecologists try to carry out this procedure as rarely as possible and only in extreme cases.

Prevention of complications after hysteroscopy

Since hysteroscopy is a serious burden not only on the female reproductive organs, but also on the entire body, after it is performed, a woman needs to take particularly serious care of her health. Immediately after the cleaning is necessary to refrain from sex for a period of 3 to 7 days. Specific periods of abstinence will determine the doctor after the inspection.

In addition, it is necessary to abandon heavy physical exertion and carrying weights, to rest more often, to avoid stressful situations. It is advisable not to go to public places (baths, saunas, swimming pools, beaches, public toilets) until the normal menstrual cycle is restored. Observance of the regimen, proper nutrition, vitamin complexes and good sleep at night will help the body recover faster after performing hysteroscopy and enter normal life mode.

Of particular importance in the posthysteroscopic period is personal hygiene. In addition to basic hygiene procedures, thorough and frequent washing-up is required during the day, especially after using the toilet. Gaskets must be changed regularly as needed. Underwear should always be clean and fresh.

What should be the selection

After the hysteroscopy procedure, women observe the appearance of scarlet blood discharge. They can be scanty, but sometimes heavy bleeding begins - in this case, immediate medical attention is required.

If red blood secretions appear after the procedure, this is not a reason to sound the alarm. Small discharges are characteristic after diagnosis, if they are scarlet, and do not cause severe painful sensations. Minor pulling pain in the lower abdomen with scanty discharge is a normal reaction.

Abundant secretions are observed only in the case when an operative hysteroscopy was performed. Devices for diagnosis violate the integrity of the tissues of the uterus, because the bleeding is justified. In this case, doctors prescribe hemostatic drugs and herbs immediately after the procedure.

Normal signs are:

  • Minor bleeding,
  • Pulling pain in the lower abdomen, which can be tolerated without painkillers,
  • Abundant discharge after the curettage procedure,
  • Bright, scarlet color of discharge.

Impact on monthly

The timing of the appearance of menstruation after hysteroscopy depends on the purpose for which the procedure was performed. If during its implementation the integrity of the tissues was disturbed, the discharge in the first days of rehabilitation would be normal.

  • If the procedure was carried out to confirm and make a diagnosis, the uterine tissue is not disturbed and the menstruation should begin on the appointed day in the previous cycle.
  • If surgery was performed, curettage, the cycle is lost, and menstruation after curettage hysteroscopy may occur later.

Regular diagnosis does not require intervention in the integrity of the tissues, because it does not affect the menstrual cycle. Monthly should be expected on the day in which they should begin on a well-established cycle.

Sometimes disruptions in the cycle are observed during endoscopic removal of polyps. The method is anemic and tissue intervention is minimal, but even such damage can affect the cycle. In addition, patients are often under stress before the procedure, which may cause a delay.

Most often, cycle disorders occur after curettage for abortion. The hormonal background of a woman is undergoing drastic changes, so it will take time to restore her well-coordinated work.

Observation of menstruation after the procedure

Both abundant and scanty periods after hysteroscopy are not always considered pathologies. If we are talking about intervention in the tissue of the uterus, copious discharge is not considered a pathology. If only diagnostics were performed, heavy periods can be a sign of unwanted mechanical damage.

The timing of the onset of menstruation depends on:

  • Compliance with therapeutic recommendations for recovery,
  • The nature of the procedure,
  • Hormonal background of a woman,
  • External stimuli: experiences, insomnia, nutrition.

Sometimes women experience severe stress, sleep poorly before the procedure - in such conditions even on other days the periods will be delayed. The hormonal background is disturbed, mainly by scraping, so it is not worth waiting for such changes during the diagnosis.

In order to recognize the dangerous symptoms in time and consult a doctor, you need to investigate in the first days after hysteroscopy:

  • The abundance of secretions
  • Consistency
  • Smell,
  • Colour,
  • The presence of pain or itching.

Blood clots can talk about the separation of the endometrium, stagnant blood - this will indicate brown, brown discharge. An unpleasant smell and itching may indicate infection, a sharp violation of acidity. If you find these symptoms, you should immediately consult a doctor.

Dangerous symptoms

The danger of the rehabilitation period is that the doctor immediately warns the woman about possible discharge after the procedure, and then she may not pay attention to serious symptoms.

If the discharge lasts for more than two days and their profusion does not decrease, this is a pathological phenomenon. Dangerous symptoms:

  • Heat,
  • Nausea,
  • Lower abdominal pain
  • Heavy bleeding,
  • Blood clots
  • Brown discharge with white streaks.

Ignoring these symptoms can lead to the development of an acute form of endometritis, it is possible the opening of uterine bleeding. If you do not seek help in time, there is a risk of infertility or even struggle for life with a strong loss of blood.

Effects of the procedure

In most cases, the manifestation of certain deviations from normal menstruation is only the reaction of the female body to the intervention, therefore it does not carry any therapeutic value. Pay attention is, first of all, at the time of occurrence and color of menstruation.

  • Delay after hysteroscopy for two or more weeks,
  • Uterine bleeding,
  • Infection
  • Damage to the uterus due to medical negligence.

The most common consequence is uterine bleeding. Abundant periods, which do not decrease in volume more than two days, require immediate medical attention. You can estimate the abnormal abundance of the month by the number of hygiene products used - if you have to change the gasket more than once per hour, immediately seek help.

Delay is a controversial violation. If it is not accompanied by other dangerous symptoms, it can be considered a normal reaction of the body - so much time it takes to restore hormonal balance. In some cases, the delay may last a month or more.

During the hysteroscopy procedure, infection is possible if it was performed negligently, without complying with the standards of hygiene and sanitation. The first signs of infection, endometritis after hysteroscopy:

  • Pulling pain in lower abdomen
  • Fever,
  • Blood discharge with a pungent odor
  • A mixture of white and blood secretions.

If you ask for help right away, treatment of endometritis is relatively easy, and complications will not appear.

Recovery period

Since the procedure of hysteroscopy is a serious intervention in the balance of hormonal background, and exerts pressure on the female reproductive organs and the entire body, it is necessary to follow all the rules of recovery. Otherwise, an omission during rehabilitation may lead to far-reaching consequences, even to infertility.

Immediately after the procedure, start a calendar, note in it all the symptoms and discharge that will be observed in the first week. Such a systematic approach to self-diagnosis will allow time to notice dangerous symptoms.

For up to seven days you need to refrain from sexual contact. This period - the averaged, more accurate period will be called only by the doctor in each individual situation and only after performing hysteroscopy.

For the period of recovery give up physical activity, carrying weights. It is necessary to rest more often and not to burden the body with physical work, as it is fraught with the appearance of bleeding. Avoid stress and strain.

It is recommended to refuse to visit saunas, baths, public toilets, beaches and swimming pools. During this period, it is likely to pick up the infection, since the hormones and acid balance are still unstable.

Especially watch out for personal hygiene. During the day, you should wash at least five times - every time after using the toilet. Underwear and pads should also be replaced as often as possible.

The basic rules of rehabilitation:

  • Refrain from intercourse for up to a week
  • Avoid serious physical exertion, weight,
  • Eat right and take vitamins,
  • Avoid public spaces
  • Watch for personal hygiene,
  • Avoid stress, lack of sleep, diet.