Summary of intervention
Dilation and curettage (D&C) is a minor surgical procedure where the opening of the womb (cervix) is widened (dilatation) and the lining of the womb is scraped out (curettage).
Number of CCG interventions in 2017/18
D&C should not be used for diagnosis or treatment for heavy menstrual bleeding because it is clinically ineffective.
UIltrasound scans and camera tests with sampling of the lining of the womb (hysteroscopy and biopsy) can be used to investigate heavy periods.
Medication and intrauterine systems (IUS) can be used to treat heavy periods.
For further information, please see:
NICE Guideline [NG88] Heavy menstrual bleeding: assessment and management
NHS Conditions Alternatives to hysteroscopy
Rationale for Recommendation
NICE guidelines recommend that D&C is not offered as a treatment option for heavy menstrual bleeding. There is very little evidence to suggest that D&C works to treat heavy periods and the one study identified by NICE showed the effects were only temporary. D&C should not be used to investigate heavy menstrual bleeding as hysteroscopy and biopsy work better. Complications following D&C are rare but include uterine perforation, infection, adhesions (scar tissue) inside the uterus and damage to the cervix.