NHS hysteroscopy after post-menopausal bleeding: pain concerns and sedation options?

[Changedforsafety]

I’ve had a little bleeding post menopause and have been referred on the 2 week appt protocol for a TV scan and Hysteroscopy . I’m not especially worried and the bleeding has since stopped. But GP confirmed best practice to check out and also sent for blood tests which have come back normal.
I’ve read the hysteroscopy leaflet and a few articles about the process, notably a campaign group advocating better treatment and BBC news articles both which describe the process as being horribly painful . I just can’t do it. My last two coils have gone awol and removal and reinsertion has been absolutely horrific , with me being sick and nearly passing out.
I’m aware that they will rebook if I say I can’t manage with gas and air/ local but are the NHS sympathetic / am I being a big wuss.

Not being a wuss
request a GA
so many threads here detailing horrific experiences.
good luck

I requested a spinal - instead of a GA - and had it with that. Just say you won’t have it done otherwise.

When you go in explain your history and ask for it to be done under general anaesthetic. A lot of women seem to get on OK with it, however I nearly passed out. I could bear the hysteroscopy but they then tried to remove a polyp which was when I started fainting. You might be ok, however given your history I would request the GA.

Not being a ‘big wuss,’ apparently 10% of women have what’s called a vasovagal syncope, which is where your body involuntarily responds to the procedure and you have a sudden drop in blood pressure and heart rate. 90% are fine, but if you’ve had similar before I would tell them.

I have a hysteroscopy under GA every year or so because of a genetic cancer risk. The NHS provides it if you are firm (and ignore the “most women tolerate it” gaslighting BS). Without GA, the procedure was by some margin the worst pain I have ever experienced - and I’ve given birth and had gallstones and pleurisy!

I was in exactly the same scenario as you @Changedforsafety. I opted for a GA based on how painful I found an attempt to fit a Mirena and the 30% failure rate in my trust which I suspect is due to women not being able to tolerate it. Some do tolerate it but many don’t. A quick poll of my female medical friends (two of whom are gynaes) and they would opt for GA. Your doctors shouldn’t be surprised if you express this preference. It will probably delay things a bit but better that than avoiding a necessary procedure altogether.

I've had one and it was more than just uncomfortable (as the leaflet i got suggested it would be). I didn't find it horrendous, however. I took 2 paracetamol and 2 ibuprofen about 45-60 minutes before I went in, and was able to drive myself home afterwards.

It has put me off having a coil though. It's definitely not an experience id be keen to do again

Here in Australia doing it without a GA is not an option. It's treated as a day surgery. You're not being a wuss at all.

Definitely recommend a GA

GA 100%! The leaflet is BS!

I had a coil insertion and hysteroscopy with gas and air, and it was the worst pain I’ve ever experienced. Definitely go for GA

I had one without anything - they said I could have gas and air if it got difficult, but then I couldn’t when I nearly begged for it (don’t know why but they said ‘just breathe’!).

I felt like it was medieval torture tbh as if they were burning my insides out - and it took me a while to feel ok after.

I was told I needed another the next year and I just said ‘no’ so offered under GA. When I saw the anaesthetist he asked if I’d tried in clinic and failed to complete, as it is so common as to why women ended up there under GA. I also felt fine after a lot faster than before.

I tend to think males wouldn’t have this painful option but I guess if some can tolerate it the NHS think it’s worth a try - but I wasn’t happy being refused gas and air and made to feel I was being mardy - when I looked into it turns out I wasn’t a mardy outlier.

I would only do it under GA now but maybe if strong pain relief is easily available you could try without. I know I have a tilted cervix if that made a difference, but coils were pretty fine - even birth was fine compared to this procedure. I don’t find any oscopy fun tbf but manage the others ok and this, for me and many, seems a very specific type of horrible.

Best wishes with it however you have it done.

I’ve been in your position too.
Make it known now, before your appointment that you will not have it done without GA and do not allow anyone to try to persuade you otherwise. Saves time and trauma as detailed by almost everyone else who has posted.

Thank you all so much and this is very much playing out what I have read about . I will insist on a GA if I need one. Hoping that the TV scan won’t show any concerns.
Seems so wrong that the pain is underplayed , but that seems to be a theme with women’s health doesn’t it ?

I’ve had hysteroscopjes. Tried it without GA and couldn’t tolerate it. Subsequent ones were under GA.

I've had 3 x hysteroscopies and can highly recommend a spinal block, which is a brilliant alternative to a GA. You are completely numb from the waist down and can have some sedation as well, so you get to be drowsy/sleep through the procedure itself, but aren't out for hours. You then just stay in the hospital until you can feel your legs again - usually takes a few hours.

I would never have any kind of vaginal procedure done now without a spinal! GAs knock me out for ages and I always end up staying a night, so a spinal is much better as I don't have any pain but am awake and go home within a few hours.

It is bizarre that it takes hours for the cervix to thin naturally during childbirth, but for this procedure they use a device to open the cervix by several cms within a few minutes and expect it all to be fine. It does seem to be a money saving exercise. There are women on here who will say that they didn’t find it too bad however, can only think it’s down to differences in physiology etc.

I hqd one privately in December. This was the first question I asked and the consultant straight away said it would be done under GA as it's 'not well tolerated' otherwise.

I've not had a hysteroscopy , but when I had a colonoscopy I requested a GA as I am a complete wuss. They were very much against this and made me feel really awful for even requesting it. I stuck to my guns but had to wait six months for the procedure. So be prepared to wait. Hopefully you have better understanding medics.

I had one a few years ago and while not pleasant, I didn’t find it particularly painful. I’ve got another coming up due to the same reasons as you, op, and now I’m really scared that it will hurt next time! I’m wondering whether to just have my coil taken out and to go for a vaginal ultrasound instead.

I had a hysteroscopy, biopsy and Mirena coil fitted three years ago by the NHS. I was given the option of local or general anesthetic from the start, there was never any proposal to do it without.

(I opted for general but on the day ended up having spinal. All good.)

I had one without any anaesthetic recently and it was actually fine in terms of pain. Im not being brave it just didnt hurt me. It was much less uncomfortable than the mirena removal and insertion

But I had been passing large clots so I wonder if my cervix was dilated anyway to let the clots through plus just luck of the day. My hospital was really nice and would have rebooked it if I said i didnt want to. It was a surprise procedure for me so they gave me a big chunk of time to think if i wanted it then or to come back for a general. They didnt make ne feel I was making a fuss and you certainly wouldnt be.

But they had to get me back for one under a general anyay to do some bits that were too complicated to tackle not under a general.

Ive seen that campaign too amd its such a shame not all hospitals are supporting people to make decisions that dont hurt them.

When I had to have mine, the consultant just went straight to GA option without even suggesting trying without. However, it had just taken her half an hour to do a biopsy - I’d warned her that I have a tilted cervix and my smears were difficult but she just shrugged off my knowledge of my own body and patronisingly said that she would be in and out in a couple of minutes. 30 minutes later…

And hence the GA no quibbles option, I think!

I was also told to just hop on the table for a biopsy, I might feel a little pinch. Bloody hell! It was horrific. The nhs website says we have no nerves down there. I beg to differ.

I am due to have a hysteroscopy in May. GA all the way. No other option was even discussed with me.

Good luck op. Hope it goes well.

They should offer you a GA. I tried it without - took painkillers as advised before it - had a biopsy and polyp removal they found when they were in there. Never experIenced pain like it (the biopsy and polyp removal) Im never doing that again without a GA. Actually i never want to see the dr that did it again either. Have the GA