Sedation for hysteroscopy

[thaneofglamour]

It has been put off for a while but the latest gynae I have seen is now saying I have to have a hysteroscopy (and a coil fitting) so I am resigned to this.

She was very gung ho and wanted to do the procedure there and then on the couch when I had no one to take me home, had not expected it, taken zero pre emptive painkillers, and was due an op in two days!

After I demurred, she said she would put me on a list for sedation, a new thing in the trust.

I have never been sedated. Can anyone tell me what the experience will be like? Will I still feel the pain? What will recovery be like?

They don't do GA at my trust and, having just had a GA, I don't want another one anyway as it made me very sick.

The thought of the whole thing is making me really miserable tbh.

I had a sedation for something else a couple of times. I would recommend it.

You get asked a lot of questions. Including your weight. They then put a cannula in your hand or arm to deliver the medication. It takes a while to kick in. Once it starts working you don't feel any pain, have no fear or concern about anything, and are totally relaxed.

I knew what was happening but didn't really care.

Another time they used sedation that made me forget everything so I couldn't remember anything bad. If there was anything bad! They use that one on children too so no fear next time.

I had to take someone with me to escort me home and stay overnight as you're not supposed to be alone.

I woke to a hysteroscopy under general anaesthetic neatly crashed my diabetic blood sugars - orange juice and neat sugar was given. No fibroid found but they still went ahead with a coil.

took a week to recover from the this (though back to work in less then 48 hours) and 3 weeks later still suffering symptoms a private scan said the fibroid hadn’t just buggered off.

Nearly 5 months later the coil came out in 15 mins when awake I’d previously been told my GP could just pull a coil input by ga but they said no sedation on site. So a hospital appointment later I’d two injections down below no gas and air and with success on my own, managed to get myself home in a couple of hours.

Thank you for outlining the procedure to me.

The only person I know who has been sedated was DH for a tube down the throat. He tried to pull the tube out under sedation and hated it which is why I asked.

What I do know , though, is three , generally very stoical , colleagues who all said having a hysteroscopy with no pain relief was traumatic.

I am under no illusion that avoiding using pain relief and sedation options is time and money saving. Whilst I think men can be treated in a very offhand way re pain, too, I do think the idea that 'many women tolerate procedures' is linked to the notions that we are expected to endure pain more than men because we experience childbirth. Telling some women that 'we all have different pain thresholds' actually makes some women feel like failures. I have no idea what my pain threshold is - all I know is I'd rather not experience pain if science has found a way to alleviate it. I felt the same when I gave birth. I don't require medals. Never been given one anyway.

There was no tube down my throat for one treatment as it was my tooth so they were in there doing surgery and I was "awake" so no choking risk and I guess not much room for a tube when they were in there anyway.

The other time was a camera scope down my throat which I was scared of so I got sedated. I don't remember anything past them getting me prepped on the bed, pushed into the room, met the doctor, got the cannula in etc.

They then put the sedation stuff in the Cannula when I was ready and the next thing I remember is being pushed on a bed down a corridor afterwards.

So I got a tube as that was part of the procedure, unlike yours!

Hopefully someone will be along who has had the procedure you are getting with the sedation and can advise how sedated you are and if you get a tube in your throat.

Oh no, I won't! What I meant is that DH remembers being sedated and it obviously didn't really work. But if you knew DH, that might not surprise you...

There is a big disparity between the level of pain or discomfort felt by different women during a hysteroscopy, and there's no telling how it will affect you before you have it. About a third of women feel only minor pain, a third feel moderate pain and a third suffer severe pain. You can't judge by others' experiences what you will feel. As you can see by previous comments some women don't have too much pain at all with them, but others find them incredibly painful and there is no telling how much pain you will feel until you are feeling it, but which time it's too late, and you are experiencing it.
Personally, I had an incredibly painful traumatic hysteroscopy, which left me with PTSD, and I'm far from alone in that.

Your hospital sounds like one of the better enlightened ones if you are being offered sedation. I would jump at the opportunity! It's exactly what the Campaign Against Painful Hysteroscopies are campaigning for.

As regards the coil fitting are you aware that medics are financial incentivised to promote and fit Mirena coils? Doctor's advice in not unbiased in this respect. A medic in the hospital recommended one for me but I was very much against them and told them this and refused. At my hysteroscopy the doctor told me that the Mirena coil was THE only treatment for my slightly thickened endometrium, and although I had already told them I didn't want one I reluctantly agreed to have one fitted thinking there was no alternative. It was only afterwards that my GP told me that I could have just taken an increased dose of progesterone instead. In the end the coil didn't suit my body and I had it removed swiftly. (I've been fine on the increased Utrogestan ever since.) The fitting was very painful, probably more so because it was done immediately after the awful hysteroscopy. Another reason to have the sedation if you actually want the coil, but please do your research carefully beforehand from a range of sources (not just NHS and other medical establishments who get the inducement) including any information of risks, such as infection, expulsion, uterine perforation and IUD migration within the body cavity as these are rarely mentioned explained. Whilst a Mirena coil suits many women it doesn't suit everyone and likewise many are not happy to accept the risk. There almost certainly will be an alternative if you ask.

It's standard practice in hospitals to be offered sedation for a gastroscopy or colonoscopy, and I've had one before for a gastroscopy and was asleep throughout the procedure, as far as I remember, and felt no pain. I woke up feeling slightly woozy recovered for a few minutes then DH drove me home. After a hysteroscopy you may have a bit of a tummy ache afterwards, but not too bad. Sedation is nothing to be worried about, and lower risk than GA, which is much lower risk these days anyway.

You can look at the Campaign Against Painful Hysteroscopy website for more information, but you are being offered sedation and I would strongly recommend that you take them up on this offer.

Thank you so much for all that info. I have been reading the Campaign stuff already. Salutary stuff.

I plan to read up more on the coil. It's being offered because of painful bleeding but serves no real contraceptive purpose. I take Utrogestan daily but the theory is I am very sensitive to progesterone in high doses so the coil kind of regulates release of it. I'm allergic to patches although I still persist with oestrogen ones. I'm 90% certain I am going to say no to the coil. The hysteroscopy is for a biopsy and 'to see what's going on up there'.

My life has been horrible since starting HRT to be honest but without it , I have night sweats and regular nosebleeds. It may of course not be the HRT!

2/3 of women feeling any pain is enough stats for me!

Are you aware that Utrogestan can be used by inserting it vaginally, which can bypass some of the side effects of progesterone taken orally, however it isn't licensed for use that way in this country, but that doesn't mean it doesn't work. Your GP probably may not know or suggest it taken this way, though, because of the licence. Again, this may be worth you looking into. I haven't tried it myself, as I'm fine taking it orally.

Also have you tried a different Estrogen patch? I was allergic to Evorel patches, but I'm fine on Estradot. My usual GP had said if I was allergic to one type of patch I would be the same for other brands, but a locum GP suggested I try Estradot and that worked for me. Or try an Estrogen gel or spray?

HRT is a bit of trial and error to find what suits you, and sadly GPs generally have very little training on menopause and HRT so it pays to educate yourself in this aspect of healthcare more than any other it seems.

I'm allergic to all patches! Currently putting up with Estradot because it's at least a small area...

I had one done about 3 weeks ago with a spinal anaesthetic. I wouldn’t have it done without that or a general.

Also allergic to the gels and sprays. I'm a sensitive soul...

I had a hysteroscopy a couple of months ago. I actually forgot to take the painkillers. It was uncomfortable and I kept closing my legs! Gas and air was my lifesaver. If I had to have another, I would take double the dose of painkillers and ask for gas and air from start to finish. The nurses were lovely but I would ask them not to talk to me so I could concentrate on breathing.

I've had one without sedation just ibuprofen beforehand.

It was really only uncomfortable because there was a lot of pressure and I felt like I was about to pee all the time.

No pain during. Normal period cramps afterwards

The nurses talk on purpose. I think it's called 'vocal local'. Quite some euphemism!

Didn’t feel anything once I had the local anaesthetic in my cervix, but was in a fair bit of pain up to that point. I had a polyp removed and other biopsy material.

I had sedation for an endometrial biopsy and was completely out of it. No recollection of anything. I had a hysterectomy a year later and I can't say I noticed much difference with the general anaesthetic.

Everyone’s different and you have no way of knowing unless you try it. I was told this, gave it a go and I’m one who would describe it as barbaric. I had a biopsy then polyp removal without any pain relief. I was in so much pain I couldn’t ask for the gas and air I was trying to breathe. The gynaecologist said there was no point having a local anaesthetic as that hurts too. I did take paracetamol and nurofen before but that didn’t help. Never doing that again. Re sedation I’ve had sedation for gastroscopies and colonoscopies and they were fine. 💐

Recent reports state that one in three women have extreme difficulty with this. There's an account on Twitter which reports on this: @HysteroscopyA
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I had polyps removed with no pain relief 2 yrs ago. Traumatising. Male gynae. He tried to get through my then 62 yr old cervix with no local anaesthetic. (Had polyps in both vagina and uterus. He told me he'd remove "the polyp", but when he was up there announced "There are several.")\

Damn near crashed my vehicle on the way home.

I was then booked in for GA with a female gynae.

She did a scan and uterine biopsy a couple of months ago. Got a local in the cervix this time. Felt that and the 'punch' of the biopsy, but it was bearable. She knew what she was doing. Was able to drive home no bother.

Have to go back next month for a hysteroscopy and polyp removal with a male gynae. Dreading it, but have been assured that I'll at least get the LA in the cervix. (Never had kids, unfortunately, so it's very narrow.)

Have been told to take ibuprofen and paracetamol beforehand. GP has given me Diazepam.