Second period after D&C is heavy: what to know

The first cycles after a dilation and curettage can vary in timing, flow, colour, and cramping. The womb lining may be rebuilding, and ovulation may not yet follow its usual pattern. A single changed period does not identify a cause. Repeated heavy bleeding can also occur with fibroids, adenomyosis, endometrial polyps, endometrial hyperplasia, polycystic ovary syndrome, or perimenopause. Heavy bleeding can contribute to iron deficiency anaemia, which may cause tiredness, breathlessness, headaches, or paleness.

Record when bleeding starts, how quickly pads become soaked, clots, pain, temperature, and any weakness. Use pads if you need to judge flow clearly, and drink fluids. Arrange a gynaecology review if the bleeding is much heavier than your usual pattern, continues beyond the expected period, or returns in another cycle. The clinician may check for anaemia, examine you, and decide whether an ultrasound or other assessment is appropriate.

Seek urgent medical help if bleeding is rapidly soaking pads, you feel faint or confused, have shortness of breath, severe or worsening abdominal pain, fever, foul-smelling discharge, or a racing heartbeat. These symptoms can signal significant blood loss or infection after the procedure and should not be judged by cycle timing alone.

Ask whether your bleeding pattern suggests a need for a blood count, iron testing, pelvic examination, or ultrasound. Ask when to expect your cycle to settle, which pain medicines are suitable for you, and whether any medicines or contraception could be affecting the flow.