Lighter or Missing Periods After Uterine Surgery: Assessing Adhesions
PeriodsArticleBring the procedure history and bleeding changes into a clinician-led assessment.
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If your periods changed after a procedure involving the uterus, contact the treating clinic to discuss the change. Give the procedure name and date, then describe what happened to your bleeding afterward. Ask what assessment is appropriate for your history.
Start with the procedure record
Adhesions can follow a dilation and curettage (D&C), including procedures after childbirth or miscarriage. Other possible causes include uterine lining infection, removal of fibroids inside the uterine cavity and endometrial ablation.1
Request the operation report if you do not have it. Bring any discharge instructions and the follow-up appointment details. Tell the clinician which part of the recovery or bleeding change you want explained, rather than trying to identify scar tissue yourself.
Describe the bleeding change
Some people with adhesions have light, absent or infrequent periods; others have no obvious symptoms. Blocked menstrual flow can sometimes cause pelvic pain. Adhesions can also be associated with difficulty becoming pregnant or recurrent miscarriage.1
Write down your usual bleeding pattern before the procedure and the dates you have afterward. Record pain separately and say whether pregnancy is something you want to discuss. Ask the clinician to consider the full history and explain other possible causes before drawing a conclusion.
Ask what the proposed test can show
Hysteroscopy lets the clinician look inside the uterus through a thin instrument passed through the cervix. ASRM calls it the most accurate method for assessing and treating adhesions. A dye X-ray called HSG or a saline ultrasound can be screening tests.1
Ask which test is being proposed, what preparation it requires and how comfort will be addressed. Confirm whether the appointment is for assessment alone or includes possible treatment. Request a discussion of the findings afterward and a copy of the report.
Leave with a follow-up plan
Treatment uses hysteroscopy to remove adhesions. Severe cases can require more than one attempt, and menstrual difficulties may continue after treatment.1
If treatment is recommended, ask what the clinician expects it to change in your case. Request written instructions for recovery and any prescribed medicines, the review date and the contact for concerns between visits. If future pregnancy matters to you, ask how the findings affect that discussion.
Period, Handled includes a Period Scorecard and a Flag It list and visit script. Use the Scorecard to organize bleeding observations and the visit script to prepare the questions you want answered. See the book.
This article is for general educational purposes only and is not medical advice. It isn't a substitute for diagnosis or treatment from a qualified healthcare professional who knows your health history. Please don't ignore professional advice or delay getting care because of something you read here. If you think you may be having a medical emergency, call 911 or your local emergency number right away. Girl Playbook does not endorse any specific product, test, or provider.
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