Day of hysteroscopy

Overview

A hysteroscopy is a procedure where a thin, lighted camera (hysteroscope) is gently put into your womb (uterus) through your vagina. It lets the doctor see the inside of your womb and often treat problems at the same time. The 'day of hysteroscopy' means the whole process from arrival to going home, which usually takes a few hours.

Yes, hysteroscopy is a very common procedure in gynaecology. Thousands of people have it each year to diagnose or treat womb problems.

Hysteroscopy is for women and people with a womb. It is most often done in people of reproductive age, but can be used at any stage of life if there is a problem with the womb lining.

Symptoms

Common symptoms

• Mild, period-like cramps during or after the procedure.
• Light vaginal bleeding or spotting for a few days.
• Feeling a bit tired or dizzy after the anaesthetic.
• A small amount of watery or pink discharge for a day or two.

Symptoms in children

• This procedure is rarely done in children. If it is, children may need general anaesthesia and the same after-effects apply, but often less cramping.

Symptoms in older adults

• After menopause, the procedure may feel a bit more uncomfortable because the cervix can be tighter. But it is still safe with appropriate pain relief. Recovery is usually the same.

Causes

Main causes

• A hysteroscopy is done to find the cause of abnormal bleeding, such as heavy periods, bleeding between periods, or bleeding after menopause.
• It is used to check the womb lining for polyps, fibroids, or adhesions (scar tissue).
• It can help diagnose or treat infertility issues like a septate uterus or retained pregnancy tissue.
• The procedure may be done after an abnormal ultrasound or smear test.

Risk factors

• Having a known condition like endometriosis or adenomyosis may increase the chance of needing a hysteroscopy.
• Being older (especially after menopause) can make the cervix tighter, but the procedure is still safe.
• Previous uterine surgery or infection may increase the risk of adhesions that need treatment.

When to see a doctor

See a doctor urgently if:

• If you have severe pain that doesn't improve with simple painkillers like paracetamol or ibuprofen.
• If you have heavy bleeding (soaking a pad every hour) more than two days after the procedure.
• If you develop a fever or chills.
• If you cannot pass urine.

Book a routine appointment if:

• For a follow-up appointment as your doctor recommends to discuss biopsy results or next steps.
• If you have ongoing mild discomfort or light bleeding beyond a week.

Diagnosis

The hysteroscopy itself is both a diagnostic and treatment tool. Before the day, your doctor will have recommended it based on your symptoms and possibly prior tests like an ultrasound. On the day, the procedure confirms or rules out the cause of your symptoms.

Tests that may be done

• Before the procedure: Usually a pregnancy test (to make sure you are not pregnant), and sometimes blood tests or an ECG if you have other health conditions.
• During the procedure: The doctor inserts the hysteroscope and may take a biopsy (tiny sample of the womb lining) for laboratory analysis.
• After the procedure: No additional tests are needed unless the biopsy shows something that requires further investigation.

What to expect at your appointment

You will be asked to empty your bladder before the procedure. You will lie on a bed with your legs raised in stirrups. The doctor will gently insert the hysteroscope through your vagina and cervix. You may feel some cramping, but it is usually brief. The whole examination takes about 5 to 30 minutes depending on whether treatment is done. You can usually go home after resting for a short time and having a drink.

Treatment

Hysteroscopy can be used to treat certain womb conditions immediately during the procedure. For example, polyps, small fibroids, or adhesions can be removed with tiny instruments inserted through the hysteroscope. If a biopsy shows abnormal cells, your doctor will discuss further treatment options.

Self-care at home

• Rest for the rest of the day after the procedure.
• Use a sanitary pad for any bleeding (do not use tampons or menstrual cups for about two weeks to reduce infection risk).
• Take simple painkillers like paracetamol or ibuprofen if you have cramps.
• Avoid heavy lifting, vigorous exercise, or sexual activity for at least 1-2 days, or as your doctor advises.

Medical treatments

After the procedure, your doctor may prescribe pain relief or, if needed, antibiotics to prevent infection. If a biopsy shows an abnormality, further treatment such as hormonal medication or a more extensive surgical procedure may be recommended. Always follow your doctor's specific instructions.

When is surgery considered?

Most hysteroscopies do not need any additional surgery. However, if the condition found is complex (like large fibroids or cancer), you may need a separate, more invasive surgery like hysteroscopic myomectomy or endometrial ablation. Your doctor will discuss this with you if needed.

Living with this condition

After a hysteroscopy, most people feel back to normal within a day or two. You can resume most daily activities the next day, but listen to your body. Light spotting may last up to a week.

Lifestyle tips

• Avoid using tampons or having sex for about 1-2 weeks to allow the cervix to close and reduce infection risk.
• Do not do strenuous exercise or heavy lifting for a couple of days.
• If you had general anaesthetic, arrange for someone to drive you home and stay with you for the first 24 hours.

Diet and exercise

Eating a balanced diet and staying well hydrated helps your body recover. Gentle walking is fine. Avoid high-impact exercise or swimming until any bleeding stops and your doctor says it is safe.

Mental health and emotional wellbeing

It is normal to feel anxious before or after a procedure, especially if you are waiting for biopsy results. Talk to your doctor or a trusted person about your worries. Most people find relief knowing they have taken an important step to understand their health.

Prevention

There is no way to prevent needing a hysteroscopy, as it is a diagnostic tool. However, you can reduce the chance of complications by following your doctor's pre-procedure instructions (like fasting if needed) and aftercare advice.

Screening programmes

Hysteroscopy itself is a screening tool. It is not used for routine screening, but rather when symptoms or other tests suggest a problem.

Complications

If left untreated

• If a condition like a polyp or fibroid is found and not treated, it may cause ongoing heavy bleeding, pain, or fertility problems.
• Infection after hysteroscopy is rare, but if left untreated, it could spread and cause pelvic inflammatory disease.
• Very rarely, the womb may be perforated (a small hole made by the instrument). This usually heals on its own, but if not treated, could cause internal bleeding or infection.

Long-term outlook

The outlook after hysteroscopy is very good. Most people recover quickly with no lasting problems. The procedure helps doctors diagnose and often treat the cause of your symptoms in one visit. Even if more treatment is needed, knowing the problem means you can get the right care. Most people feel positive about having had the procedure.

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