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Menopause

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Original poster

Hysteroscopy - Pain Relief

62 replies

HebeJeeby · 07/06/2025 08:43

I’ve just been taken off the cancer pathway as I’ve had a test of the lining of my womb and all is ok. I’ve been experiencing bleeding whilst in HRT and the Dr wanted to get me tested. The lining of my womb is 2mm thicker than it should be hence the test which has come back normal. However, due to the excessive bleeding they want to do a hysteroscopy to investigate the bleeding.

I’ve read that this procedure can be very painful and indeed 2 women I know found the pain excruciating and couldn’t continue. One woman had to then have it under general anaesthetic. I rang to ask about pain relief and got told to have a paracetamol one hour before my appointment. I said that i wasn’t happy with this for the reasons I’ve just written and the NP is going to call me on Monday to discuss. I found the initial procedure to suck cells form my womb very painful but it was bearable as it only lasted about 30 seconds. Apparently a hysteroscopy can take anything from 5 to 30 minutes.

Has anyone had a hysteroscopy and what was it like? Did you get offered or have any pain relief. I’m feeling so anxious about it and can’t believe that anyone would think I took to shove a camera into the womb and not think that this is going to hurt. Can I insist on proper pain relief like a local anaesthetic? Thank you.

OP posts:

dementedpixie · 07/06/2025 08:47

My sister found it very painful and like giving birth. Part way through they had to go and get gas and air for her as it wasn't offered as an option at the start

planestrains · 07/06/2025 08:53

I had a hysteroscopy privately and the Consultant strongly recommended a General Anesthetic, which is what I had

DrSeuss · 07/06/2025 08:58

Had a uterinepolyp removed a few weeks ago under similar circumstances. My hospital put as gas and air nozzle in my hand as I say down . Apparently standard. Worked brilliantly. Didn't know it wasn't standard.

Coffeeishot · 07/06/2025 09:01

I had one after I was sterilised, I have a medical issue so they wanted to make sure , anyway the pain is horrific I'm not going to lie I was also told 2 paracetamol after I left my legs went wobbly and a passing nurse had me sit down, they should at the very least provide gas and air. Take something stronger op if you can op,

DisplayPurposesOnly · 07/06/2025 09:02

Had a hysteroscopy and biopsy in Jan23. Planned to have a general anaesthetic but ended up with a spinal one on the day. Didn't feel a thing. Local anaesthetic was also an option.

Spinal takes longer to recover from (waiting for feeling to come back into your legs) but with general they said no driving for 48hrs.

Don't let them fob you off.

Coffeeishot · 07/06/2025 09:03

I see others have had Gas and Air, op ask for it.

ThePussy · 07/06/2025 09:05

I had one with local anaesthetic in my cervix which made things much more bearable. The previous one, with no pain relief was horrendous, the doctor was an evil bitch, who told me it was difficult because I was overweight. I asked the last doctor if this was the case, and she said not - I had a high cervix, so she had to use a longer speculum. She was quick, efficient, and it was relatively pain free. The one before, I was upside down and crying and she took nearly an hour to get into my cervix, while shouting at me (another doctor came in to see what was going on).

PeggyMitchellsCameo · 07/06/2025 09:06

Basic pain relief…. absolute joke.
I insisted on sedation at the very least and got it so I was out cold, and needed the strongest codeine they could give me for a week.
There is a campaign to stop this practice without sedation or GA, it’s barbaric.
I would refuse and dig my heels in and don’t be swayed by anyone telling you otherwise.

vxa2 · 07/06/2025 09:11

I had a hysteroscopy in April also to investigate post menopausal bleeding after the ultrasound showed a thickened womb lining. I am in HRT and haven’t had a period for over 3 years.
When the hysteroscopy was booked I told them I wanted a local and they made a note. I took paracetamol and ibuprofen 30 minutes before.
On the day the consultant explained that the local itself could be painful as it involved several injections but so she wouldn’t routinely use a local but that I should start with gas and air. The gas and air was ready to go from the start and the nurse encouraged me to use it. Everyone was very kind. In the end I had a local as they were finding it hard to get the camera past the cervix. The local was the most painful part and the gas and air really helped while they did the first 2 or 3 injections. After that I couldn’t feel anything.

Afterwards they kept checking my pain and they offered me codeine. After 30 minutes or so and a cup of tea I felt ok so I didn’t have the codeine.

I hope that helps. I think my experience was probably the best it could be but this was because the staff were so kind and I felt they listened to my concerns and I knew what was going to happen. I was told from the outset that if I wanted to have a general I could and I could stop the procedure at any time. I would say advocate for yourself and be prepared to be really firm in telling them what you want. Be clear and insistent.

Original poster

HebeJeeby · 07/06/2025 09:12

Thank you everyone who has replied, you have given me the validation indeed to stand my ground.

OP posts:

cloudjumper · 07/06/2025 09:16

There is a wide range of experiences for hysteroscopy. I’ve had two, and didn’t need pain relief for either. For me, it was like a longer smear test, uncomfortable, but bearable (and that included taking a biopsy).

Chasingsquirrels · 07/06/2025 09:17

cloudjumper · 07/06/2025 09:16

This was my experience as well.

ThisPithyJoker · 07/06/2025 09:18

I've had one and I wouldn't describe it as painful but it was very unpleasant. I felt very close to passing out and they had to pause and lean the bed back so the blood goes to your head to keep you conscious. The rest they did with me sorting if upside down. Apparently that's pretty common. I was astounded that it was done without offering any sedation. Given you've had a similar procedure before, I would expect it to be pretty similar to the previous procedure (painful) and plan accordingly. Everybody's body is different and you know better than them how it will respond. All the best and congratulations that the test came back positively

ThisPithyJoker · 07/06/2025 09:22

If it helps to add context, I've had several other procedures in the area (colposcopy, repeat biopsies, a large LLETZ etc) and the hysteroscopy was the worst but the hysteroscopy was pre-children. I would imagine it wouldn't be much different to your previous procedure except in terms of duration.

Misspotterer · 07/06/2025 09:23

It's different for everyone. I've had one with paracetamol and local injection. It was uncomfortable but bearable. Wasn't offered anything else.
I'm having another one in a couple of weeks and was offered general anaesthetic or sedation. Got my pre -op next week and I think I'm going to go without again otherwise I'll need to stay in all day and find someone to drive me (my usual person has just had surgery!).
I've had friends who had to stop the procedure and rebook with general anaesthetic.
You absolutely should have the choice though.

pencilcaseandcabbage · 07/06/2025 09:26

cloudjumper · 07/06/2025 09:16

I'd agree with this. Have a look back at some of the other threads on here. Some women have a terrible time, others are ok. I've now had 4 (complete with biopsies, polyp removal and one cyst drain) and each time had a local anaesthetic gel, plus ibuprofen or paracetamol. They were all fine - a bit tender at times, but better than several of my smear tests.

BrentfordForever · 07/06/2025 09:30

I did this privately as part of my IVF cycle few years ago

i I had GA, the consultant was very gentle and everything was very bearable

good luck !

soontobeconfirmed · 07/06/2025 09:31

I'm having one under general next week.

LizzyLine · 07/06/2025 09:44

Turned down general because no one to collect me from hospital. Paracetamol and GP prescribed Valium. Did deep breathing, mindfulness etc. it was so painful I vomited. Definitely push for proper pain relief.

JinglingSpringbells · 07/06/2025 10:34

To be honest every woman is different.

I had one with nothing and found it fine - no worse than a smear.

A lot depends on the skill of the doctor doing it. I had to be dilated so it took some time but I can honestly say it was okay. I had it done privately and knew my consultant already. I had a choice of what pain relief (or not) I wanted.

I had the option of a local if I wanted (at the time) and reschedule if I had that and it didn't work.

My preference was definitely for no GA so I went ahead with that in mind.

No one can tell you how it will be for you. the RCOG has done a survey and their guidance says that 70% of women find it okay with no GA, but obviously no one knows how they will be in advance.

JinglingSpringbells · 07/06/2025 10:39

You need to balance the pros and cons. A GA has a risk, you have not to eat for several hours beforehand, and have someone to take you home and be with you for 24 hrs after any GA.

Groovee · 07/06/2025 10:48

I was given a GA for mine.

Original poster

HebeJeeby · 07/06/2025 10:55

Thank you all for relying. I’ve just looked up a cytoscopy which looks like a very similar procedure in terms of time and invasiveness and the NHS website says that an anaesthetic is routinely offered.so why is it not offered for a hysteroscopy? Misogyny in medicine or for other reasons?
https://www.nhs.uk/tests-and-treatments/cystoscopy/how-its-done/

How a cystoscopy is done

Find out what’s involved in having a flexible or rigid cystoscopy.

https://www.nhs.uk/tests-and-treatments/cystoscopy/how-its-done

OP posts:

JinglingSpringbells · 07/06/2025 11:04

In the link, a GA is used for a rigid scope- not a flexible one. The scopes for a hysteroscopy are narrower and flexible.

If you have had a biopsy (which you say you have) the instrument used is the same size as a scope for a hysteroscopy. I've had both (like you) .

The procedure can be very quick (5 mins) but if access takes longer, it can be 30 mins. That's how long mine took but I'm being totally honest and saying the pain was not noticeable. The worst bit was having my legs in the air for that time!

Can you agree on the use of a local injection?

Are you on combined continuous HRT or sequential? If it's sequential the cut-off point of 5mm doesn't apply because the lining varies over the course of the 4 week cycle. If it 's higher and you're on sequential, you usually don't need investigations. The BMS advice is to adjust HRT first to see if the bleeding stops.

ScaryM0nster · 07/06/2025 11:10

It’s sensible to have a conversation around how pain is managed and options, and what happens if it’s too painful during the attempt.

There’s a balancing activity required, as things like GA and spinal anaesthetic have a much higher risk of side effects or complications than oral pain medication or gas & air do. They also have longer recovery periods and need someone else to supervise you for a period.

I’d suggest not seeing GA as the gold standard and anything as as inferior. It’s the most effective for pain avoidance during the procedure. It’s also the highest risk for complications, and requires the most aftercare and has greatest impact on your life for the following weeks.

If you can manage with oral
pain relief and the potentially gas and air then that’s likely to be the ‘better’ option for you as complications from that are almost non existent. If you can’t, then it’s not the right solution for you.

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