A hysteroscopy is a procedure to examine the inside of your uterus (womb) using a thin, flexible tube with a light and camera (called a hysteroscope). It is used to:
- Diagnose conditions (e.g., abnormal bleeding, polyps, fibroids).
- Treat problems (e.g., remove growths, take biopsies, or remove misplaced contraceptive devices).
- Investigate infertility or recurrent miscarriages.
It is minimally invasive and often done as an outpatient procedure.
Why Might I Need a Hysteroscopy?
Your gynaecologist may recommend a hysteroscopy if you have:
- Heavy, irregular, or postmenopausal bleeding.
- Suspected polyps, fibroids, or adhesions (scar tissue).
- Unexplained pelvic pain or infertility.
- Abnormal results from a cervical screening or ultrasound.
Before the Procedure
- Scheduling: The test is usually done when you’re not menstruating (ideally days 5–12 of your cycle).
- Pregnancy test: Required if there’s any chance you could be pregnant.
- Pain relief: You may be offered painkillers (e.g., ibuprofen) to take beforehand.
- Anaesthesia:
- Local anaesthetic (numbing the cervix) is common.
- General anaesthetic may be used for longer or more complex procedures.
- Preparation:
- Avoid sex, tampons, or vaginal creams for 24 hours before.
- Arrange transport home if having sedation/general anaesthetic.
During the Procedure
- Positioning: You’ll lie on a couch with your legs supported (similar to a smear test).
- Inserting the hysteroscope:
- The cervix is gently dilated (widened) if needed.
- The hysteroscope is passed through the vagina and cervix into the uterus.
- Normal saline is used to expand the uterus for better visibility.
- Examination/treatment:
- The camera sends images to a screen.
- Biopsies or minor treatments (e.g., removing polyps) may be performed.
- Duration: 10–30 minutes (longer if treatment is needed).
After the Procedure
- Recovery: Most women go home the same day.
- Common side effects:
- Mild cramping or spotting for 1–2 days.
- Temporary dizziness (if sedation was given).
- Self-care:
- Rest for 24 hours.
- Avoid sex, tampons, or swimming for 48 hours (to reduce infection risk).
- Use sanitary pads (not tampons) for any bleeding.
- Pain relief: Paracetamol or ibuprofen can help with cramping.
Risks and Complications
- Common (temporary):
- Light bleeding, cramping, or vaginal discharge.
- Rare but serious:
- Infection (symptoms: fever, foul-smelling discharge).
- Uterine perforation (a small hole in the womb – may require further treatment).
- Heavy bleeding (soaking a pad hourly).
Follow-Up
- Results: Discussed at a follow-up appointment (usually 2–6 weeks later).
- Further treatment: Depends on findings (e.g., medication, surgery).
Frequently Asked Questions
Q: Will it hurt?
A: Most women feel mild discomfort. Pain relief options are available – discuss this with your doctor.
Q: Can I eat before the procedure?
A: If having local anaesthetic: yes. If sedation/general anaesthetic: follow fasting instructions.
Q: Are there alternatives?
A: Ultrasound or MRI scans may be used, but hysteroscopy provides the most direct view.
Q: How soon can I return to work?
A: Most women resume normal activities within 1–2 days.
eGynaecologist Advice:
- Hysteroscopy is a safe and effective way to diagnose/treat uterine issues. You may feel cramping (similar to period pain) and pressure or mild discomfort.
- You should contact your gynaecologist immediately if you experience severe pain, heavy bleeding, or fever.
