Preparing for hysteroscopy

Overview

Hysteroscopy is a procedure that uses a thin, lighted tube (called a hysteroscope) to look inside your uterus. It helps doctors diagnose and sometimes treat problems such as abnormal bleeding, polyps, or fibroids. Preparing for hysteroscopy means following your doctor's instructions to make the procedure safe and comfortable.

Yes, hysteroscopy is a common procedure used to investigate and treat many uterine conditions.

It is performed on women and people with a uterus who have symptoms suggesting a problem inside the uterine cavity.

Symptoms

Common symptoms

• Heavy or prolonged menstrual bleeding
• Bleeding between periods
• Pelvic pain or cramping
• Abnormal spotting after menopause
• Difficulty getting pregnant

Symptoms in children

• Hysteroscopy is rarely performed in children. If needed, symptoms would be the same as in adults but may include vaginal bleeding before puberty.

Symptoms in older adults

• Postmenopausal bleeding
• Pelvic pressure or discomfort

Causes

Main causes

• Uterine fibroids (non‑cancerous growths)
• Endometrial polyps (growths in the lining of the uterus)
• Uterine scarring or adhesions (Asherman's syndrome)
• Abnormal uterine bleeding due to hormonal changes
• Cancer or precancerous changes of the endometrium

Risk factors

• Age over 40
• Obesity
• High blood pressure (hypertension)
• Diabetes
• Use of tamoxifen (a breast cancer treatment)
• History of uterine surgery or infection

When to see a doctor

See a doctor urgently if:

• Any bleeding after menopause (even a single spot)
• Bleeding that is very heavy or lasts longer than usual
• Severe pelvic pain that comes on suddenly

Book a routine appointment if:

• Irregular periods or spotting between cycles
• Pain during sex or pelvic exams
• Difficulty getting pregnant after trying for a year

Diagnosis

Your doctor will review your symptoms, perform a pelvic exam, and usually order an ultrasound (often a saline infusion sonogram) before recommending a hysteroscopy. Hysteroscopy itself is both a diagnostic and treatment tool.

Tests that may be done

• Pelvic ultrasound (transvaginal ultrasound)
• Saline infusion sonogram (fluid ultrasound)
• Endometrial biopsy (sample of the lining)
• Hysteroscopy (direct visual exam)

What to expect at your appointment

During the procedure, you may be awake with a local anaesthetic or have sedation. The doctor gently inserts the hysteroscope through your vagina and cervix. You may feel some cramping. The procedure usually takes 10–30 minutes. Afterward, you might have mild cramping and spotting for a few days.

Treatment

Treatment depends on what is found during the hysteroscopy. If a polyp, fibroid, or scar tissue is seen, the doctor may remove it during the same procedure. This is called operative hysteroscopy. If the lining looks abnormal, a biopsy may be taken. Sometimes further treatment with medication or another surgery is needed.

Self-care at home

• Rest for the remainder of the day after the procedure.
• Use a sanitary pad for any spotting (no tampons for 1–2 weeks).
• Take over‑the‑counter pain relievers if approved by your doctor.
• Avoid sexual intercourse, swimming, and using tampons for two weeks or as directed.

Medical treatments

If the hysteroscopy shows hormonal imbalances, your doctor may suggest hormonal medications to regulate bleeding. If polyps or fibroids are found, they can often be removed during the hysteroscopy. In cases of endometrial hyperplasia (thickening) or early cancer, further treatments such as a D&C or medication may be recommended.

When is surgery considered?

Most hysteroscopy problems are treated during the procedure itself. In rare cases, if the issue is too large or complex, a separate surgery like laparoscopic myomectomy or hysterectomy may be needed. Your doctor will discuss all options with you.

Living with this condition

After hysteroscopy, most people return to normal activities within a day or two. You may have mild cramping or spotting for a few days. If you had treatment for a condition, symptoms like heavy bleeding often improve quickly. Follow your doctor's advice about activity and follow‑up appointments.

Lifestyle tips

• Keep a menstrual diary to track any changes in bleeding or pain.
• Avoid heavy lifting or strenuous exercise for the first week.
• Stay hydrated and eat a balanced diet to support healing.

Diet and exercise

A healthy diet rich in fruits, vegetables, and whole grains can help your body heal. Light walking is fine after a day or two. Avoid vigorous exercise until your doctor says it's safe.

Mental health and emotional wellbeing

Waiting for results from a biopsy or coping with a diagnosis can be stressful. It's normal to feel anxious or worried. Talk to your doctor or a counsellor if you need support. Many uterine conditions are treatable, and treatment often improves quality of life.

Prevention

Many conditions that lead to hysteroscopy, like fibroids or polyps, cannot be fully prevented. However, maintaining a healthy weight, managing blood pressure, and staying active may lower your risk of hormonal imbalances and uterine problems.

Screening programmes

Regular gynaecological check‑ups and reporting any abnormal bleeding to your doctor early can help catch problems when they are easiest to treat.

Complications

If left untreated

• Heavy bleeding can lead to anaemia (low iron) and fatigue.
• Polyps or fibroids can cause chronic pain and make it harder to get pregnant.
• Precancerous changes may progress to uterine cancer if not monitored or treated.

Long-term outlook

The outlook is generally very good. Hysteroscopy is a safe, effective way to diagnose and treat many uterine conditions. When problems are found early, treatment is often successful, and symptoms improve. Most people recover quickly and return to their normal life.

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