Hysteroscopy lets a doctor look directly inside the womb (uterus) using a thin camera passed through the vagina and cervix. It can find causes of bleeding or fertility problems and, often in the same sitting, treat them. There are no cuts on the skin.
What it is
A hysteroscope is a long, thin, lighted telescope. Fluid (such as saline) or carbon dioxide gas gently widens the womb so the doctor can see the lining clearly on a screen.
| Type | Purpose |
|---|---|
| Diagnostic | Looks for structural problems in the womb |
| Operative | Treats what is found, e.g. removes a polyp; can be done in the same session |
Because diagnosis and treatment can happen in the same session, many people avoid a second procedure.
Who it's for
- People with fertility problems or recurrent miscarriage, to check the womb cavity.
- Heavy or irregular bleeding, or bleeding after menopause.
- Suspected polyps, fibroids bulging into the cavity, scar tissue (Asherman's syndrome) or a septum present from birth.
- Finding a lost coil (IUD) whose threads cannot be seen.
MedlinePlus adds a few more reasons: checking a thickened womb lining, taking a tissue sample (biopsy), and investigating repeated miscarriages.
For fertility, the aim is to make sure the inside of the womb is a healthy place for an embryo to implant.
Step by step
- TimingWith regular cycles it is usually booked in the week after your period ends, when the lining is easier to see.
- Pain reliefDepending on the plan, you may have no anaesthetic, local anaesthetic, sedation or a general anaesthetic.
- Camera inThe hysteroscope is passed through the vagina and cervix; the cervix may be gently widened first.
- LookFluid or gas widens the womb and the doctor inspects the lining and the openings of the tubes.
- Treat if neededFine instruments can remove polyps, fibroids, scar tissue or a septum, or take a tissue sample.
- Rest and go homeAfter a short rest most people go home the same day.
What it feels like
Discomfort is often like period pain. Some people feel sick or faint. A diagnostic hysteroscopy usually takes 10 to 15 minutes; Cleveland Clinic notes the range is five minutes to over an hour, depending on what is done.
- Cramping for a couple of days is normal.
- Light bleeding can last up to a week.
- Most physical activities can be resumed within 1 or 2 days.
- With a general anaesthetic, you will need someone to take you home.
- Avoid exercise and sex until pain and bleeding have settled.
After removing scar tissue or a septum, ASRM notes your doctor may place a small balloon or device in the womb for a while, or prescribe antibiotics or oestrogen, to help the lining heal.
MedlinePlus says hysteroscopy takes from 15 minutes to more than an hour, depending on what is done. Most people go home the same day, and a watery discharge can continue for several weeks.
How to prepare
- Discuss pain relief options with your doctor beforehand.
- Consider ibuprofen or paracetamol about an hour before, if suitable for you.
- Follow fasting instructions if you are having a general anaesthetic.
- Arrange time off for the rest of the day, especially after sedation or a general anaesthetic.
- Don't have the procedure if you might be pregnant; tell the team.
- Don't use tampons, have sex, swim or take baths for about two weeks afterwards, as Cleveland Clinic advises.
- Your doctor may prescribe medicine to soften the cervix, taken about 8 to 12 hours before.
- You may be asked to stop blood thinners such as aspirin, ibuprofen, naproxen or vitamin E about a week before.
- Tell the team about all medicines and whether you could be pregnant.
These steps come from MedlinePlus; your own doctor's instructions come first, for example on whether ibuprofen is suitable on the day.
Ask your doctor whether your hysteroscopy is diagnostic, operative or both, what pain relief is planned, and whether you need someone to take you home.
Risks and side effects
Complications are uncommon. ASRM reports them in about 2 of every 100 procedures; Cleveland Clinic reports less than 1%. They include a small hole in the womb wall (perforation), infection, heavy bleeding, scarring inside the womb and, rarely, fluid overload or anaesthetic reactions.
ASRM notes that perforation is the most common complication; small holes usually heal on their own.
| Side effect | What sources describe |
|---|---|
| Cramping | Common, for a couple of days |
| Light bleeding | Up to a week |
| Infection | Small chance; treatable with antibiotics |
| Perforation | Rare; small holes usually close on their own |
MedlinePlus also lists damage to the cervix, and rarely damage to the bowel or a need for further surgery to repair an injury.
Seek help for heavy bleeding, fever, worsening pain or smelly discharge after the procedure.
How DBN does it
At DBN, hysteroscopy is done as a day case, so you go home the same day. It is priced at consultation; the first consultation is free and prices are confirmed then.
Ask at your consultation whether hysteroscopy is recommended in your case, and what pain relief is planned.
When to see a doctor
- Heavy, irregular or bleeding between periods.
- Any bleeding after menopause.
- Two or more miscarriages.
- Trying to conceive without success, especially after an ultrasound showed something in the womb.
Questions & answers
Will I have any scars?
No. The camera goes through the vagina and cervix, so there are no skin cuts.
Do I need to be asleep?
Not always. Short diagnostic checks are often done with little or local anaesthetic; longer treatments may use sedation or general anaesthetic.
When in my cycle is it done?
Usually soon after a period ends, when the womb cavity is easier to see. If your cycles are irregular, your doctor will choose a suitable time.
Related DBN services
Related articles
Sources
- Hysteroscopy — NHS
- Hysteroscopy — Cleveland Clinic
- Laparoscopy and Hysteroscopy patient education booklet — ASRM ReproductiveFacts
- Hysteroscopy — MedlinePlus (U.S. National Library of Medicine)