Hysteroscopy

A closer look inside the womb.

What is a hysteroscopy?

A hysteroscopy is a procedure that allows us to examine the inside of the uterus (womb) using a very thin telescope-like camera called a hysteroscope. This is passed through the vagina and cervix into the uterus, allowing direct visual assessment of the womb lining (endometrium).

It is a key diagnostic and sometimes therapeutic tool used commonly in gynaecology.

When might a hysteroscopy be recommended?

We may suggest a hysteroscopy if you are experiencing:

• Heavy, irregular, or prolonged bleeding
• Bleeding between periods or after menopause
• Suspected polyps or fibroids
• Unusual vaginal discharge
• Recurrent miscarriage
• Fertility concerns

• Issues with coil placement (insertion or removal)

What does the procedure involve?

A hysteroscopy can be done in two ways:

• Outpatient hysteroscopy: Performed in the clinic without a general anaesthetic
• Day case under general anaesthetic: Performed in theatre, usually when treatment is also required

The hysteroscope is gently inserted through the vagina and cervix. Saline fluid is used to open the womb cavity so we can see the lining clearly. We examine for any abnormalities such as polyps, fibroids, adhesions, or congenital anomalies. A small sample (biopsy) of the lining may also be taken.

If you’re having the procedure in clinic, you’ll lie comfortably on a couch with your legs supported. A speculum may be used initially (as during a smear test). You’re welcome to bring someone with you, and you can choose to watch the procedure on a screen if you’d like. The whole process typically takes around 15–20 minutes.

Preparing for your hysteroscopy

Preparation depends on the setting:

If you’re having an outpatient procedure:

• You can eat and drink as normal.
• You may wish to take paracetamol or ibuprofen an hour beforehand to minimise discomfort.

If under general anaesthetic:

• You will be asked not to eat or drink for at least 6 hours before.
• You will need someone to accompany you home afterwards.

In both cases, we may ask for a urine sample on arrival to rule out pregnancy.

Can I have a hysteroscopy during my period?

Hysteroscopy can still be carried out during a period, but feel free to discuss this with us in advance if you’re unsure. Sometimes we may recommend delaying the procedure so we can optimise the treatment you need.

Is a hysteroscopy painful?

Some women find an outpatient hysteroscopy uncomfortable, like strong period cramps. Pain is usually short-lived. If needed, we may use a local anaesthetic to help ease the passage of the hysteroscope. Most women tolerate the procedure well, and we always aim to make the experience as comfortable as possible. You will always be in control of the procedure, and we can stop at any time and arrange for it to be performed under general anaesthetic instead.

What happens afterwards?

You may have:

• Mild cramping (like a period)
• Light vaginal bleeding for a day or two
• A faint or dizzy feeling if done as an outpatient (this usually settles quickly)

You should be able to return to your usual routine the same day if you feel well enough. If you’ve had a general anaesthetic, we recommend resting for the remainder of the day. Avoid driving until you’re fully recovered.

You can resume physical activity, including sex, the next day unless advised otherwise.

Results

If we’ve taken a biopsy, the results are usually available within 5–7 days. We will contact you to discuss the findings and next steps.

Are there risks?

Hysteroscopy is a very safe and routine procedure. As with any medical intervention, there are small risks, including:

• Cramping or discomfort during and after the procedure
• Light bleeding
• Feeling faint
• Infection (rare)
• Uterine perforation (very rare)

If you experience a fever, worsening pain, offensive discharge, or heavy bleeding after your procedure, please seek medical advice.

Are there alternatives?

In some cases, an ultrasound or MRI can give helpful information. However, hysteroscopy remains the gold standard for assessing the womb lining directly and obtaining a biopsy if needed.

We’re here to help

At ObGyn Matters, our team of consultant gynaecologists are experienced in performing hysteroscopies with a gentle and patient-centred approach. If you have symptoms or concerns and think a hysteroscopy may be appropriate, we’re here to guide you through every step of the process.

Consultants

	Dr Chris Barnick Consultant Obstetrician and Gynaecologist
	Dr Alison Wright Consultant Obstetrician and Gynaecologist
	Dr Marina Fernando Consultant Gynaecologist
	Dr Deepa Janga Consultant Obstetrician and Gynaecologist
	Dr Nicole Zenner Consultant Gynaecologist