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?

@Elisandra

Agree it’s appalling, and many women will trust that if a GA isn’t offered then it isn’t needed - which is in this case is not necessarily true.

This. I trusted what I was told. Didn't question it. Never again.

It's true you don't get a GA for colonoscopies, but you get a LOT of sedation and pain relief in an IV. I was given something really strong for all of mine, and if I asked for more sedation or pain relief not a problem - it was topped up. Spent a couple of hours recovering in the outpatient ward then went home. It's insane that gynaecological procedures are not treated similarly.

That's because men have colonoscopies.

@Babdoc

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.

Yeah, this seems a really outdated belief that you have to stay overnight after GAs. In other countries, well, I had an ACL reconstruction at 8am, GA of about 3 hours. Went home later that afternoon (I did have an IV still installed, nurse came by to flush it, give drugs and some injection for the swelling, physio came by to set up a CPM machine). Even here, I've had short-acting GA's for procedures and you go home after a couple of hours.

I had to have a colonoscopy under a GA and an endoscopy under one. Was discharged a couple of hours later.

I had a hysteroscopy and dye test under X-ray when I was having investigations for infertility. I was 27. Painful, and wasn’t given any information about it before I had it.

Had another in outpatients aged 47, with biopsies, absolutely excruciating. No pain relief was offered, not even Entonox, which would have helped. As someone who had never had children, even smears are very painful, but this was absolutely awful.

At the very least, I’d want entonox available, yet when I was so uncomfortable during the 2nd hysteroscopy, I was told by the consultant, in quite an irritable way, that I I couldn’t cope with the ‘discomfort’, I’d have to have it done under a GA. Like I was making a a fuss over something so minor, it was embarrassing for him to witness it.

And no, I was given an information leaflet after the procedure, not before.

I’ll definitely be looking at the information you have provided, OP, and signing up for improvements to be made.

The astounding variety of lived experiences just in this one thread!

There's a Facebook group, it's private and you have to be invited to join.

To find it, search The Campaign Against Painful Hysteroscopy Page and then message them for an invitation to join the private closed group.

Loads of support, resources and campaign news.

I'd urge everyone to reply to the government consultation on women's health.

www.gov.uk/government/consultations/womens-health-strategy-call-for-evidence/womens-health-strategy-call-for-evidence

I see the Campaign Against Painful Hysteroscopy are also tweeting actively at @HysteroscopyA

I’ve just completed the survey. It jogged my memory on a few things.
Thank you, OP, for drawing my attention to this.💐

I had a biopsy taken from my womb, done unexpectedly on a routine appointment, it was fine, no painkillers or anything. Then on having a follow up, a different consultant wanted to remove some polyps, he only performed hysteroscopies under GA. So I had a GA, it was fine and I was discharged a few hours later.
But, does anyone know what the first procedure I had was called? I'm assuming it wasn't a hysteroscopy? The consultant did clamp my cervix, but didn't insert a camera.

@AutumnBrooke I just wanted to say that I had the same experience as you with the same procedure. Again, like you, I have a high pain threshold, two sections, a terrible riding accident, failed IVF, miscarriages without medication.

That specific procedure haunts me to this day. I couldn't cope and blacked out, woke up in a and e. Where it was suggested I try again with a parecetamol, then they questioned if I had a stomach bug as I threw up everywhere. It's actually making me want to cry thinking about it. Just awful.

@Polly99

A hysteroscopy where they just have a look and don't do anything is uncomfortable but doesn't always hurt, certainly mine didn't. It's when they take biopsies or whatever not giving pain relief seems cruel. What got me was the paracetamol post crash caesarean. Can you imagine a man being cut from hip to hip and coping with a couple of headache pills the next day? And being expected to look after another person to boot? It's insane.

Not always. Other times other procedures take place at the same time. During mine I had laser treatment to remove adhesions.

I was under general anaesthetic for both of mine fortunately. It has been discussed about if it would be without anaesthetic, sedation, local or general but the assisting doctor at my appointment insisted to the consultant that general was the best option for the procedure.

I'm very glad for that.

Absolutely agree. Yes it’s not the majority of women who experience severe pain with a hysteroscopy but there’s no way of knowing who will in advance, so doing it without a GA is completely unacceptable unless it’s at the woman’s request after being informed of the benefits and risks.

Sorry if the following upsets anyone...

I ended up seriously traumatised by what should have been a straightforward procedure (removal of mirena coil). My GP was unable to remove it after a long and painful attempt. She referred me to have it removed under sedation except when I got there they didn’t sedate me. I find smear tests excruciating so knew it would be bad but it was horrendous. I told the gynae that I find speculums really painful and asked if they could use the smallest one - she rolled her eyes at me, and used a larger one. I cried throughout - she kept the speculum open for over 30 mins. Then she removed it and without asking for consent inserted her entire hand into me and started slamming her other hand into my abdomen trying to feel for it I guess?

As soon as she stopped I ran out of the room, without my clothes - a nurse came to find me and suggested I make a formal complaint.

Ended up needing a hysteroscopy - they wanted to do it with a local and I refused. I was treated like a pathetic weak woman but got my GA in the end.

Took me years to be able to have a smear test after this, and that was only after a GP gave me a talking to.

Not always. Other times other procedures take place at the same time. During mine I had laser treatment to remove adhesions.

Do you maybe mean a laparoscopy rather than a hysteroscopy (unless the adhesions were inside your womb)? I’ve had six laparoscopies and they are definitely not something you want without a GA although I know a few women who’ve had them with spinal anaesthetics instead.

Tbf my periods were horrendous and far more painful so I was pretty used to suffering. Maybe that’s why it didn’t trouble me too much.

Comments like this, whilst not intended to most likely, aren't helpful.

My adhesions were causing excruciating pain twice a month. Some the procedures I had pre hysteroscopy were so sore and painful. The pain after the two hysteroscopies was great. I was used to pain. I have a pretty high pain tolerance. It made no difference to whether I'd tolerate pain during two invasive procedures.

Woman shouldn't have to face any pain to undergo invasive and intimate medical procedures if there is any way to avoid it..

I've had several babies vaginally, 2 without minimal pain relief, and I still find smears painful. As for changing my IUD! I need 3 diazepams to get through that. So forewarned is forearmed: should I ever have the misfortune to need hysteroscopy or any similar procedure, thanks to this thread I know to insist on adequate pain relief beforehand.

Some gynaes treat women as sentient human beings. I did not heal properly after my first birth, and was restitched when dc1 was 8m. It was done under GA and I was back home the same day. By the time I returned for a check-up a month later, I had learned from MN and my NCT group that virtually everybody else who had had a post-birth repair had had it under local or spinal. I asked my obstetrician why she did mine under general. The answer was "Un-necessarily distressing to be awake and I was not going to put you through that." She was lovely, my ob-gyne.

I don't know whether she's still practicing, but if you ever have the opportunity to be treated by Melanie Davis, take it. She was the most patient-centred gynaecologist I have ever had.

Sinkgirl

They were inside my womb

I didnt even know I was having this procedure till the letter dropped through my door.

I went to the 2 week cancwe clinic for my cervix, swabs clear but they want to donate cervical biopsy then I also received a second letter for this other procedure.

I've had 3 kids with no pain relief, but smear tests are very painful as my cervix is anterior and always a struggle to get to. So I cant imagine this being fun at all as to what you're all describing.

Seriously thinking of cancelling it all.

@Abraxan

Sinkgirl

They were inside my womb

Oh bless you, that must have been so painful. I have endometriosis and adenomyosis so adhesions everywhere but not in my womb so far! Glad you managed to get them treated and hope it helped

Tbf my periods were horrendous and far more painful so I was pretty used to suffering. Maybe that’s why it didn’t trouble me too much.

I’m on morphine daily due to endometriosis and adenomyosis and I still any internal exam excruciating thanks to adhesions and retroverted uterus.

It has thanks Sinkgirl.
I had Asherman's Syndrome following a c section with Dd. I'd already had issues with fertility beforehand abd has cervical stenosis to an extent. Had a number of years of intense pain before a locum doctor finally listened to me and referred me. Took two ops but they were mainly removed.
Been several years and although I have some pain it's nothing like it used to be.

I had a hysteroscopy last May including a Myosure procedure, womb biopsy and Mirena fitting. I was warned by the gynae beforehand that some women can't tolerate the pain, but I decided to try with just a local anaesthetic. I can't say it was the most pleasant experience, but the three nurses with me were lovely, I had gas and air and I guess the whole thing took around 45 minutes.

In my case it was fortunate that I had it done when I did as the biopsy found endometrial cancer, rare for someone my age (47) and less than three weeks later the whole lot was taken out anyway.

I was warned by the gynae beforehand that some women can't tolerate the pain

Well that’s certainly one way of putting it. What a dick. Obviously if it’s unbearable then it’s because you have a low pain threshold 🙄

I am petrified of GA so have always opted to have my hysteroscopies done without anything. I am on the waiting list to have a third one and again will opt for it to be done without anaesthesia. I have always been offered the choice of pain relief though I can’t imagine women going through the whole procedure in agony, surely the gynaecologist would holt the hysteroscopy if she was in any form of discomfort? I do wish there were many, many more female gynaecologists though. I have been under that department for many years and sadly, IME very few male gynaes are that understanding.

@SpnBaby1967

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

I had one two weeks ago and had no worse than a mild discomfort. The staff were lovely and kept telling me they would stop immediately if I needed it.

Best of luck!

@Svag

My old gynecologist intended cutting out my lymphoma (fibroid) without sedation or GA. He got as far as injecting local into my cervix, at which point I started urgently telling him to stop. He asked the nurse whether he should, and she said yes (thank goodness for her).

It remained agonizing for perhaps thirty minutes afterwards. He said it couldn’t possibly still be painful. I guess he meant the local must have caused numbness, but I suspect something went into spasm.

I had it done under GA in hospital eventually and the bleeding was something else. I’m so glad I stopped him.

But imagine telling a patient they can’t be in pain. The arrogance of that still astonishes me. I wish I’d been strong enough to ask him whether he thought I was making it up.

I still went back to him. Pretty sure if it happened now I wouldn’t.

Fancy having to ask if you should stop, when the patient is asking you to stop because it is too painful! He was "lucky" he had a nurse to advise him, as to continue without consent would have been assault.