Hysteroscopy without anaesthetic is a women's rights issue

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'Being a woman means living with pain!'

Ever heard that lie?

Ever nodded along with it, resignedly accepting some intrusive gynaecological procedure that causes you excruciating pain?

BECAUSE THEY WERE OPERATING ON YOU WITHOUT ANY ANAESTHESTIC?

I was just instructed to take two Nurofen before the hysteroscopy. I had read online that it would be painful. I asked for gas and air beforehand and was told off for being silly: “We don’t do things at this hospital which hurt people”. The gas and air was refused.

I had a biopsy. It was very painful. I was clinging to the nurse. They were unable to remove my fibroids/polyp. I have been waiting two years to go through it all again under general anaesthetic.

I didn’t get tea and biscuits. I got to walk out into a waiting area full of other women, blood and water running down my legs, and made to sit on a big pad in this large open waiting area. Humiliating.

Maybe this was worse because I’ve only ever had C-Sections. I would advise someone else experiencing bad pain to speak up and ask them to stop. I didn’t. I felt powerless with my legs strapped down.

My sister described her hysteroscopy as “no worse than a smear test”. Agree with a PP that experiences vary. If someone is in pain, don’t soldier through. Speak up. I wish I did.

@SpnBaby1967

I have this procedure later this month, now you have all terrified me!

Ignore. I've had two hycosy procedures and one hysteroscopy and felt next to nothing.

Having an anaesthetic would have meant an overnight stay and comes with its own risks.

@InconvenientPeg

My experience wasn't like that at all. I had one where they took a biopsy and the worst it got was just a sharp twinge at a couple of points.

They were very good about asking me if I was ok, and had discussed how much pain there might be, and that I could stop at any point and opt for the procedure with anaesthesia.

I felt really confident that they were listening. An all female care team. For me, that's always made a difference in how confident I felt about being listened to.

Not saying this to take away from anyone's experience of pain, but more to reassure anyone that has got one coming up. But definitely they should talk it through and make it clear you can stop at anytime.

That's exactly what mine was like.

And I was given painkillers and a mild sedative beforehand and told that I could have gas and air if I asked for it. I was able to change in a little private room before and after and given coffee and biscuits afterwards, again in a quiet room. I think the treatment I had was brilliant even thought I and all the staff were masked throughout. NHS, and the level of care and explanation I experienced was great.

Some of the other experiences sound very distressing.

I had a hysteroscopy last summer.
Bit of a cock up as I thought I was just going to see a gynae doctor & hadn't realised that I was going to have an internal exam so no chance to take paracetamol beforehand.
It was a little uncomfortable & ungainly.
It reminded me of my first smear - put your feet in the stirrups & scootch to the end of the table.

I took some paracetamol when I got home.

Now the colonoscopy I'd had the week before under mild sedation....? That was bloody painful!

I've had a colonoscopy with sedation and it was fine.

I recently had a Mirena coil fitted (my fourth one) it was absolute agony, I was practically on the ceiling. The female gynae was enormously unsympathetic and uncaring. I actually wrote a letter of complaint (first ever complaint to a doctor). I got a half arsed apology, sadly full of lies about what had happened during and after the procedure, and was told that I should have a GA if I ever needed the procedure again.

I honestly felt like I'd been brutalised afterwards, luckily dh was waiting outside to take me home. I sobbed and shook in the car. I don't think that's an acceptable way to feel after a medical procedure and I agree, it is a feminist issue. Woman are expected to tolerate these extremely painful procedures without appropriate anaesthesia. It's obscene.

If I ever have to have an HSC I will be asking for a GA.

@CherryMaple
I didn’t get tea and biscuits. I got to walk out into a waiting area full of other women, blood and water running down my legs, and made to sit on a big pad in this large open waiting area. Humiliating.
This is disgraceful. I'm so sorry you were treated like this.

Name changing for this as it's TMI

I had to have a bunch of gynae procedures a few years ago for problem periods. The vaginal ultrasounds were mildly uncomfortable, and the first biopsy I had hurt due to a minor mishap with the speculum as much as the actual removal of the sample, but only for a few seconds. The hysteroscopy was horrific, and having a bunch of medical instruments shoved where the sun does not shine without adequate pain relief is not something I'd recommend to anyone. Unfortunately I'm not a good candidate for a GA, but I saw on twitter someone suggesting that it might be possible to get it done with a spinal block instead, so if I ever need to have another one I'll be asking about that.

I’m a retired anaesthetist.
Yes, LittleValleyOverNearSlice, most minor gynae procedures can be performed under a spinal anaesthetic. (So can many major ones, such as hysterectomy, if laparoscopy is not involved)
Many of my patients were either frail and elderly with post menopausal bleeding, or morbidly obese, and both groups were much safer with a spinal than a GA.
And diggingatrench, sorry, no, you are wrong - minor gynae procedures do not require an overnight stay after a GA. They are done as day cases and you will be discharged after two hours.

I have had 2 biopsies-I of them I had anaesthetic and it was uncomfortable but fine. The other one I had was barbaric; it was in another part of the country to the first, there was no anaesthetic even offered, i had people in the room to hold me down and they literally stabbed at me and made me bleed so much I had swabs in me for hours, could barely walk I was in that much pain.

I had mine done privately about 5 years ago. The consultant mentioned doing it without sedation but strongly recommended not opting for that approach. I’m bloody glad I followed his advice.

I am so sorry for all who have suffered so much and so unnecessarily.

I’m a retired anaesthetist.
Yes, LittleValleyOverNearSlice, most minor gynae procedures can be performed under a spinal anaesthetic. (So can many major ones, such as hysterectomy, if laparoscopy is not involved)

Is there a reason why spinal anaesthetic wouldn’t be offered? I’ve only been offered a choice of nothing or GA.

I had a hysteroscopy when I lived overseas for a while, the procedure was billed as being under general. However I had read that here that wasn't needed and I felt that I didn't want a GA if it wasn't necessary. I didn't have the GA however it was carried out as if it was a surgical procedure, in an operating room, very gently etc.

This is clearly a procedure that should be GA as the standard but you can opt out if you want.

I have a tilted uterus and a badly scarred cervix (cone biopsy). I insisted on a GA for hysterescopy and coil fitting. (I was in my 40s before I started to assert my right to not be subject to horrible pain against my wishes.)

Having an anaesthetic would have meant an overnight stay and comes with its own risks.

I don’t dispute the risks associated with anaesthesia but my procedure was done as a day case, similar to other (non gynae) procedures I have had under GA.

Signalbox, if you are otherwise healthy, a GA will allow faster discharge than a spinal, as it takes a few hours for the spinal to wear off.
My colleagues tend to assume that most patients prefer to be unconscious for their op, particularly if it is potentially embarrassing like gynae or rectal procedures, so may not think to offer the option of a spinal.

It is also a wee bit quicker to perform, so a theatre list will be able to turn over more patients per session if they are mostly GAs.

@Babdoc thankyou for your expert input! Mine was done under GA, I was amazed how quickly I came out of it and how quickly I felt normal. I was home within a few hours.

@teezletangler

I had the procedure done under general anaesthetic as a day hospital in-patient after the unexpected attempt at an outpatient procedure was abandoned. It was absolutely fine.

But doesn't this seem like a reasonable approach? If it's too painful, then abandon the procedure and reschedule for a GA in hospital. I do agree about giving information regarding pain relief options beforehand, and possibly having more options including mild sedative. But what happens if everyone decides they want a GA? You'd never get through the waiting list! And then you'd end up with unhappy patients and delayed diagnoses, possibly leading to worse outcomes.

We don't offer GA for colonoscopies either, or for vasectomies. My DH was one of the unfortunate people who experienced vasectomy as excruciating, even with local anaesthetic. There are plenty of unpleasant procedures that men undergo as well, with minimal pain relief.

I don't think it's ok to make women suffer for the sake of waiting lists actually. We should be offered information and a choice, and then be allowed to make an informed decision before a procedure has to be abandoned due to excruciating pain. Many people prefer to avoid GAs whenever they can, so it really isn't as if everyone will opt for one. GA lists should be properly funded.

As for men undergoing painful procedures with minimal pain relief, we are taking about women here so I don't see the relevance of that. The number of gynae and obstetric procedures women are expected to endure in pain is a disgrace. My own experience was barbaric, and I passed out. The O & G registrar, despite being warned that my cervix had a birth injury which had made coil insertion almost impossible previously, forced a dilator through my cervix with no warning.

I've been present for hundred of vasectomies and there really is no comparison to gynae procedures for the vast majority of men (and post op questionnaires bear that out) not that we should be comparing as I said.

Interestingly, whilst the UK doesn't offer GA for colonoscopy, other countries do, and for endoscopy.

[quote SocialConnection]Well, time's up.

The Campaign Against Painful Hysteroscopy is showing her teeth and roaring with rage.

Caroline Criado Perez and Caitlin Moran have both recently tweeted about the horrors that so many women are put through during IUD insertion, hysteroscopy and other procedures.

The Campaign have gathered many distressing and remarkably consistent accounts by women detailing what the NHS have put them through.

Because it is NHS policy to carry out hysteroscopies on women:

At outpatients' appointments

In an examination room that is not an operating theatre

With no warning that the operation is going to take place at that appointment where you think you're going to talk about your scan results

With infantilising and misleading language that does NOT explain what's about to be done to you

No checking whether you might have suffered any past trauma that might well trigger PTSD

And therefore without your informed consent

With no advice about or provision of painkillers, or any form of anaesthestic or sedation

No checking how you will get home safely afterwards

No aftercare - just a pad bunged at you and off you go, bleeding, shocked, tearful, shaking, traumatised

Sounds unlikely?

It's the reality for many women.

www.hysteroscopyaction.org.uk/[/quote]
I experienced heavy pressure into having a hysteroscopy and biopsy in just this situation but I refused . I had experienced typical peri meno heavier periods more spaced out, and one episode of very heavy bleeding - an initial scan had queried possible fibroid but the second showed it was c-section scarring . There was nothing to suggest a sinister cause, and I told the doctor I wanted to wait and see what happened re my periods as peri meno flooding seemed common. He really put a huge amount of pressure on me, telling me of a patient who had also had normal scans but later developed cancer. He seemed annoyed that I was saying no to the procedure, told me my GP had sent me there to rule out cancer, even though this had not been mentioned to me at all, my GP had said she wanted me checked for fibroids.
It was a horrible experience even without the operation.

Mine was done with a cervical block. Dilated, scope inseted, biopsies taken. I've had worse period pains to be truthful. It wasn't as bad as I had imagined.

Babdoc thank you that’s really helpful to know. I have so much anxiety over the idea of being knocked out. I said to my husband it’s feels like going out when you’ve got the builders in. You can’t keep an eye on what they’re up to!

Oh god.
I had one a few years ago, thought my appointment was to talk results of scan, and a possibility of a hysterectomy. I had 5 minutes with an arrogant male doctor, who told me it was a simple and straightforward procedure that would be over in no time. Mild discomfort.
I was then wheeled into a full on operating theatre, heaps of people, bright lights etc… it seriously was the most horrendous pain I’ve ever experienced. Gas and air, no relief. I begged him to stop, absolutely bawling, not being able to breathe. Was told it’s because I had had csections. Making it sound like it was my fault. He marched off, a nurse helped me back to my curtained off bed, I fainted, nearly vomited everywhere. Was left there to put my pants back in and make my way home. My husband picked me up, had no idea what was happening until I called him sobbing my guts out. I tried to make a complaint to my female go, who was dismissive. I was booked in 2 weeks later with a general.
I was sick, shocked, shaken, even typing this is making me feel wobbley.

Btw, I am NOT a dramatic person in the slightest!

For balance, I’ve had 2 HyCoSys which were no more painful or uncomfortable than a smear test, and a hysteroscopy with a bit of local anaesthetic into my cervix, which was also fine

I don’t have a very high pain threshold at all but it really wasn’t that bad
And it was a private procedure covered by BUPA, so not a case of cost cutting

The other thing… he said, all your problems will be sorted with a mirena. I said, nope, don’t want one. He then told me it really was for the best and convinced me in all of a minute to get one fitted at the same time as this procedure.
Thank god it didn’t happen, looking back I was steamrolled into decisions that I had no time or information around.
When I went in for the general, I told everyone from the orderly, to the nurse, to the doctor, to reception, no fucking mirena.

I had a thread on here last month about my hysteroscopy and how horrific it was. I have complained to the NHS but no reply as yet.

I get that some women aren't bothered this procedure any more than they are by a smear test but I was very fucking bothered. I think I actually passed out with the pain a couple of times. The fact that about a quarter of women experience absolute agony means we are no tiny minority.

I'm so glad this is being discussed loudly and publicly. I had never heard of the procedure, trusted the medical professionals who assured me I would experience no more than "minor discomfort" and so didn't ask anything further. It's no exaggeration to say that my trust in the NHS has been shattered. The letter from the hospital had a little tag line on the top - "safe and compassionate care, every time". Was it fuck.