Alternatives toDilation & Curettage

There are alternatives to D&C depending on your condition.

For some women, uterine problems may be diagnosed and/or treated with a less invasive procedure. Depending on the underlying cause, problems like heavy bleeding, irregular bleeding and period pain may be successfully treated with medication alone.

Less invasive diagnostic procedures

Transabdominal ultrasound

During this ultrasound, the uterus and other pelvic organs can be seen. It can be helpful in diagnosing the cause of pelvic pain, abnormal bleeding, menstrual problems, or infertility.

Transvaginal ultrasound

During this ultrasound, a probe is inserted in the vagina so the uterus and other pelvic organs can be seen.  While it’s more invasive than a transabdominal ultrasound, it shouldn’t be painful.  The main advantage is that it can produce clearer images than a transabdominal ultrasound.

Fluid contrast ultrasound

This is a special type of ultrasound to see the cavity of your uterus. A tiny plastic tube is put through your cervix and into your uterus. It’s used to insert a sterile solution that inflates the cavity of the uterus. A transvaginal ultrasound is then done.

For all types of ultrasound, you may be asked to drink plenty of fluids before and not empty your bladder. A comfortably full bladder makes it easier to see the uterus.

Endometrial pipelle biopsy

This is an alternative way of taking a sample of the lining of your uterus. A speculum is put in your vagina to see your cervix, then your gynaecologist passes a narrow tube through it and into your uterus. They’ll apply suction to the tube to remove a sample of the lining. It can be done in your doctor’s rooms. The sample taken will be sent for examination by a pathologist.

Medication

There are a number of medications that can be used for heavy and/or irregular periods and period pain:

• Anti-inflammatories like ibuprofen or naproxen can reduce bleeding and relieve period pain.
• Tranexamic acid (Cyklokapron®) can reduce menstrual bleeding.
• Certain oral contraceptives can help to regulate your cycle, reduce bleeding and relieve period pain.
• Progestogen tablets can help with bleeding if it’s caused by a hormone imbalance.
• Intra-uterine contraceptive devices (IUDs) like Mirena® and Kyleena® can reduce bleeding by thinning the lining of your uterus.
• Injectable contraceptives like Implanon® and Depot Provera® are also helpful.

Medical termination of pregnancy

This is an alternative to D&C for terminating a pregnancy up to 9 weeks gestation. Medical termination is a 2 stage process. The first stage involves taking a tablet called mifepristone which blocks progesterone, the hormone necessary for your pregnancy to continue. A second medication, misoprostol is taken 24 to 48 hours later. This causes the contents of your uterus to be expelled. Your body will naturally miscarry without the need for surgery or anaesthesia.

Overall, medical termination is a low risk, non-surgical option with a high success rate. For advice and counselling regarding termination of pregnancy, visit Family Planning NSW, Family Planning VIC, Family Planning ACT, Sexual Health Quarters WA, Family Planning TAS, Children By Choice QLD, or Family Planning NT.

Suction curette

This is an alternative surgical method for evacuating product of pregnancy from the uterus, either for an incomplete miscarriage or termination of pregnancy.  Compared to D&C, suction curette is associated with slightly shorter procedures and decreased blood loss and pain.

Hysteroscopy

Hysteroscopy is a similar procedure to D&C but your surgeon uses an instrument with a light and camera to check the inside of your uterus for any abnormalities. They can then either sample or remove any abnormal tissue. This procedure is often preferred to D&C if small, localised abnormalities are suspected.