If your gynaecologist has recommended a hysteroscopy, you may have questions about what the procedure involves, whether it will be painful and how long recovery might take.
A hysteroscopy is a procedure used to examine the inside of the uterus (womb). It can help investigate symptoms such as abnormal uterine bleeding and identify conditions including uterine polyps, certain fibroids and changes to the uterine lining.
Understanding what happens before, during and after a hysteroscopy can help you prepare for your appointment and make informed decisions about your care.
This guide explains the procedure, preparation, recovery and potential risks, including what to discuss with your gynaecologist beforehand.
What Is a Hysteroscopy and Why Is It Performed?
A hysteroscopy involves passing a thin instrument called a hysteroscope through the vagina and cervix into the uterus.
The instrument contains a small camera that allows your gynaecologist to examine the uterine cavity on a monitor.
Unlike some other gynaecological surgical procedures, hysteroscopy does not usually require any incisions in the abdomen.
Your gynaecologist may recommend the procedure to investigate:
- Heavy, prolonged or irregular menstrual bleeding
- Bleeding after menopause
- Suspected uterine polyps or submucosal fibroids
- Abnormalities of the uterine lining
- Certain fertility concerns or recurrent pregnancy loss
- Scar tissue or adhesions within the uterus
In some cases, hysteroscopy can also be used to remove polyps, treat certain fibroids or obtain tissue samples for laboratory analysis.
At Bloom Women’s Health, our gynaecologists provide consultations for a range of uterine health concerns, helping patients understand their investigation and treatment options.
How to Prepare for a Hysteroscopy
Preparation depends on whether you are having a diagnostic hysteroscopy or a procedure involving treatment, as well as the type of anaesthesia planned.
Your healthcare team will provide specific instructions before your appointment.
Discuss Your Medical History and Medications
Before undergoing hysteroscopy, inform your gynaecologist about any existing medical conditions, previous surgery, medication allergies and medicines you currently take.
This includes prescription medications, over-the-counter medicines and supplements.
Certain medications may need to be reviewed before the procedure, particularly medicines that affect blood clotting.
Do not stop prescribed medication unless instructed by your treating healthcare professional.
Check Whether Fasting Is Required
If your hysteroscopy involves sedation or general anaesthesia, you will generally need to follow fasting instructions beforehand.
For procedures performed without general anaesthesia or sedation, fasting may not be necessary.
Your healthcare team will explain the requirements based on your planned procedure.
Consider Your Menstrual Cycle
A hysteroscopy is sometimes scheduled shortly after a menstrual period because the uterine lining may be thinner and easier to examine.
However, timing depends on the reason for the procedure, your menstrual cycle and your clinical circumstances.
A hysteroscopy should not be performed during pregnancy. Your healthcare team may recommend a pregnancy test beforehand.
Arrange Transport and Time for Recovery
If you are receiving sedation or general anaesthesia, you will need someone to accompany you home.
You should also arrange time away from work or other responsibilities if recommended.
For many patients, hysteroscopy is performed as a day procedure, meaning an overnight hospital stay is not usually required.
What Happens During a Hysteroscopy Procedure?
Although the exact process varies, hysteroscopy generally involves several steps.
Step 1: Anaesthesia or Pain Management
Before the procedure, your healthcare team will explain the available options for managing pain and discomfort.
Depending on your circumstances, a hysteroscopy may be performed without anaesthesia, with local anaesthesia, sedation or under general anaesthesia.
Step 2: Inserting the Hysteroscope
The gynaecologist carefully passes the hysteroscope through the vagina and cervix into the uterus.
Sterile fluid is introduced to gently expand the uterine cavity and provide a clearer view of the uterine lining.
Step 3: Examining the Uterus
Images from the hysteroscope appear on a monitor, allowing your gynaecologist to identify abnormalities such as polyps, fibroids or adhesions.
Step 4: Performing Additional Procedures if Needed
Depending on the findings and what has been agreed beforehand, your gynaecologist may collect a biopsy or use specialised instruments to treat certain abnormalities.
A diagnostic hysteroscopy is often completed within approximately 5 to 30 minutes. Procedures involving treatment may take longer.
Is a Hysteroscopy Painful?
Pain and discomfort during hysteroscopy vary considerably between individuals.
Some patients experience cramping similar to menstrual pain, while others may find the procedure significantly more uncomfortable or painful.
Factors that may influence discomfort include the type of procedure, whether instruments are passed through the cervix and the pain management approach used.
For hysteroscopy performed while awake, pain relief options may include oral medication or local anaesthesia.
Sedation or general anaesthesia may be considered depending on the clinical circumstances, procedure and patient preferences.
If you are undergoing an awake hysteroscopy, you can ask for the procedure to be stopped if you experience unacceptable pain.
Discussing any concerns with your gynaecologist beforehand is important, particularly if you have experienced painful pelvic examinations or procedures in the past.
What to Expect After a Hysteroscopy
After the procedure, you may spend some time in a recovery area, particularly if you have received sedation or general anaesthesia.
Your healthcare team will monitor your recovery and provide instructions before you return home.
Cramping and Mild Discomfort
Lower abdominal cramps similar to period pain are common after hysteroscopy.
These symptoms may last for a few hours or several days.
Your doctor may recommend suitable pain relief based on your medical history and the procedure performed.
Light Vaginal Bleeding or Spotting
Light bleeding or spotting can occur following hysteroscopy, especially if a biopsy has been taken or tissue has been removed.
This may continue for several days.
Your healthcare team will explain what level of bleeding is expected and whether sanitary pads should be used instead of tampons during recovery.
Feeling Tired After the Procedure
If you have received sedation or general anaesthesia, you may feel tired, drowsy or nauseated afterwards.
Follow the instructions provided by your anaesthetist, including restrictions on driving and operating machinery.
How Long Does Hysteroscopy Recovery Take?
Recovery time depends on whether the hysteroscopy was diagnostic or operative, the type of anaesthesia used and your individual response.
Following an uncomplicated diagnostic hysteroscopy, many patients can return to their usual activities within a day or two.
However, patients who undergo more extensive procedures, such as removal of a uterine polyp or fibroid, may require additional recovery time.
Your gynaecologist will advise when it is appropriate to return to work, exercise and other activities.
Returning to Exercise and Daily Activities
Gentle activities may be resumed relatively quickly after an uncomplicated procedure if you feel well.
More strenuous exercise or physical work may need to be postponed, especially after operative hysteroscopy.
Sexual Activity and Tampon Use
Your healthcare team may recommend temporarily avoiding sexual intercourse and tampon use to reduce infection risk while your uterus and cervix recover.
The recommended period varies depending on the procedure and your treating clinician’s instructions.
Always follow the specific aftercare advice provided to you.
What Are the Possible Risks of Hysteroscopy?
Hysteroscopy is generally considered a safe procedure, but complications can occur.
Potential risks include:
- Infection
- Excessive bleeding
- Injury to the cervix
- Uterine perforation, where an instrument creates a small hole in the uterine wall
- Complications related to anaesthesia
- Fluid-related complications during some operative procedures
Some procedures may also be unable to be completed as planned.
The likelihood of complications depends on your medical circumstances and the type of hysteroscopy performed.
Your gynaecologist will discuss the relevant risks, potential benefits and alternative investigations or treatments before obtaining your consent.
When Should You Seek Medical Attention After Hysteroscopy?
Mild cramps and spotting can be expected after a hysteroscopy. However, certain symptoms may indicate a complication requiring prompt assessment.
Contact your healthcare professional if you experience:
- Heavy vaginal bleeding
- Severe or worsening abdominal pain
- Fever or chills
- Unusual or unpleasant-smelling vaginal discharge
- Persistent vomiting or feeling significantly unwell
If you experience severe symptoms or cannot obtain prompt medical advice, attend an emergency department.
Frequently Asked Questions About Hysteroscopy
Can I Go Home on the Same Day as a Hysteroscopy?
Most hysteroscopies are performed as day procedures, meaning patients can usually return home without an overnight hospital stay. However, this depends on the procedure, anaesthesia and individual medical circumstances.
Will I Need Time Off Work After a Hysteroscopy?
Some patients can return to work the following day after an uncomplicated diagnostic hysteroscopy. Others may need additional time, particularly following operative treatment or general anaesthesia. Your healthcare team will provide individualised advice.
Can a Hysteroscopy Detect Cancer?
A hysteroscopy allows the gynaecologist to examine the uterine lining for abnormalities. If suspicious tissue is identified, a biopsy may be taken and examined by a pathology laboratory. A hysteroscopy alone cannot definitively diagnose or exclude all cancers.
Can a Hysteroscopy Help With Heavy Periods?
A hysteroscopy may identify structural causes of heavy menstrual bleeding, such as uterine polyps or certain fibroids. In some circumstances, these abnormalities may be treated during the procedure. Whether hysteroscopy is suitable depends on the underlying cause of the bleeding.
Is a Hysteroscopy the Same as a Hysterectomy?
No. A hysteroscopy examines the inside of the uterus and may involve treating certain abnormalities while preserving the uterus.
A hysterectomy is a separate surgical procedure involving removal of the uterus.
Discussing Hysteroscopy With a Gynaecologist in Brisbane
If you have been experiencing abnormal uterine bleeding, have been diagnosed with a uterine polyp or have been referred for further investigation, a gynaecologist can help determine whether hysteroscopy is appropriate.
At Bloom Women’s Health, our team provides specialist gynaecological consultations to assess symptoms, review investigation results and discuss management options.
You can learn more about our hysteroscopy services in Brisbane, including diagnostic hysteroscopy, biopsies and treatment of selected uterine conditions.
Disclaimer: This article provides general educational information about hysteroscopy and typical recovery experiences. It does not replace personalised medical advice, diagnosis or treatment. Preparation, procedural risks and recovery instructions vary between individuals. Always follow the advice of your treating gynaecologist or another qualified healthcare professional regarding your specific circumstances.