Hysteroscopy Explained: What Happens and How It Feels

If you have been told you need a hysteroscopy, it is completely normal to feel a little anxious. Most women have never heard of the procedure before their appointment, and the unknown is often the hardest part. In this post, I explain what a hysteroscopy is, why it is done, what happens on the day and how you are likely to feel afterwards.

What is a hysteroscopy?

A hysteroscopy lets your gynaecologist look inside your womb using a hysteroscope, a thin telescope with a light and camera at its tip. The hysteroscope passes gently through the vagina and cervix, so there are no cuts or stitches. Images appear on a screen, and you can usually watch if you would like to. You can read more on our hysteroscopy page.

Why might you need a hysteroscopy?

Most of these procedures are arranged to find the cause of a symptom. Common reasons include heavy or irregular periods, bleeding between periods and bleeding after the menopause. The test is also used to investigate fertility problems, repeated miscarriage, or a thickened womb lining seen on an ultrasound scan.

Some procedures are diagnostic, simply looking and perhaps taking a small sample. Others are operative, which means small problems such as polyps or fibroids can be treated at the same time. Being able to diagnose and treat in one visit is one of the real advantages of this approach.

What happens on the day

Many women have the procedure as an outpatient, while awake, and the whole appointment usually takes 10 to 30 minutes. You will lie on a couch with your legs supported, much as you would for a smear test. A small amount of fluid gently opens up the womb so that the lining can be seen clearly. If a sample is needed, it is taken through the hysteroscope and sent to the laboratory.

Some women prefer a general anaesthetic, and others need one because a larger treatment is planned. This is always your choice to discuss with your gynaecologist beforehand. Even with a general anaesthetic, you will usually go home the same day.

Does a hysteroscopy hurt?

This is the question I am asked most often, and the honest answer is that experiences vary. Many women feel period-like cramps during a hysteroscopy, which settle quickly afterwards. Others find it more uncomfortable, and that matters. You should never feel that you have to put up with significant pain.

Taking ibuprofen or paracetamol about an hour beforehand often helps, as long as these medicines are safe for you. Local anaesthetic can be used on the cervix, and you can ask to pause or stop at any point. If you are worried, tell us in advance so that we can plan the best approach together. The Royal College of Obstetricians and Gynaecologists has helpful patient information on outpatient procedures.

Recovery and aftercare

Recovery after a hysteroscopy is usually quick. Most women return to normal activities the same day or the next, although it is sensible to take things easy for a few hours. You may notice some cramping and light bleeding or discharge for a few days, which is normal.

Contact your doctor if you develop heavy bleeding, a high temperature, smelly discharge or pain that is getting worse rather than better. These can be signs of infection, which is uncommon but needs prompt treatment. Using sanitary pads rather than tampons for a few days also helps reduce that risk.

Getting your results

Your gynaecologist can often tell you straight away what they saw during the hysteroscopy. If a biopsy was taken, the laboratory results usually follow within a couple of weeks. Depending on what is found, the next step might be reassurance, medication or further treatment. For heavy periods, national guidance on heavy menstrual bleeding sets out the options available, and our page on menstrual disorders explains common causes.

Most importantly, a hysteroscopy is a routine, well-established procedure, and most women find it far easier than they feared. If you have symptoms you are worried about, or would like to discuss whether you need a hysteroscopy, please get in touch with our team to arrange a consultation.