Heavy first period after hysteroscopy: what to know

Hysteroscopy uses a small camera to look inside the uterus. If a biopsy or polyp removal was performed, light bleeding and cramping can occur during recovery. The next menstrual bleed may not match your usual timing or flow while the lining settles, but the procedure cannot explain every new symptom.

Heavy bleeding can also relate to the reason for the procedure, such as polyps, fibroids, adenomyosis, or thickening of the uterine lining. Infection or an uncommon procedure-related problem should be considered when bleeding comes with fever, worsening pain, or offensive discharge. Prolonged loss may lower iron stores.

Follow the discharge advice from the facility that performed the hysteroscopy. Use pads while bleeding is being assessed, record how quickly they become wet, and note clots, pain, temperature, and discharge. Avoid guessing whether bleeding is a period if it started soon after the procedure; call the treating team with the procedure date and what was done.

Seek urgent care for bleeding that rapidly increases, faintness, severe or worsening pelvic pain, fever, chills, foul-smelling discharge, or marked weakness. Contact the procedure team promptly if the flow remains much heavier than your usual period or does not settle as expected.

Ask whether a biopsy or removal was performed, what bleeding pattern is expected after that procedure, and when results will be discussed. Ask whether you need a blood count, iron assessment, examination, or ultrasound.