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Painful Hysteroscopy

What is a hysteroscopy? Should it be painful? And why could you need one?

Hysteroscopy is a procedure that allows your doctor or gynaecologist to look inside your uterus in order to diagnose and treat causes of abnormal bleeding. Hysteroscopy is done using a hysteroscope, which is a thin camera that is inserted into the vagina through the cervix to examine the cervix and inside of the uterus (womb). A speculum is sometimes inserted first (same one that is used when a smear test is done). Hysteroscopy can be either diagnostic or operative.
Diagnostic hysteroscopy is used to diagnose problems of the uterus.
Operative hysteroscopy is used to correct an abnormal condition that has been detected during a diagnostic hysteroscopy. If an abnormal condition was detected during the diagnostic hysteroscopy, an operative hysteroscopy can be performed at the same time, avoiding the need for a second surgery. During operative hysteroscopy, small instruments used to correct the condition are inserted through the hysteroscope.

Your doctor may perform hysteroscopy to correct the following uterine conditions:

  • Polyps and fibroids: Hysteroscopy is used to remove these non-cancerous growths found in the uterus.
  • Adhesions: Known as well as Asherman’s Syndrome, uterine adhesions are bands of scar tissue that can form in the uterus and may lead to changes in menstrual flow as well as infertility. Hysteroscopy can help your doctor locate and remove the adhesions.
  • Septums: Hysteroscopy can help determine whether you have a uterine septum, a malformation (defect) of the uterus that is present from birth.
  • Abnormal bleeding: Hysteroscopy can help identify the cause of heavy or lengthy menstrual flow, as well as bleeding between periods or immediately after menopause. Endometrial ablation is one procedure in which the hysteroscope, along with other instruments, is used to destroy the uterine lining in order to treat some causes of heavy/excessive bleeding.

Hysteroscopy is used to investigate post-menopausal bleeding. The most common reason for this investigation is to rule out womb (uterine) cancer. The procedure shouldn’t be painful, and, for those women experiencing exceptional discomfort, an anaesthesia should be offered, according to NHS protocols. But in reality it can be very different: in fact, there are more and more testimonies of women experiencing horrendous pain without being given any anaesthesia.

Post menopause, due to the cervix being closed, women can encounter severe pain as the hysteroscope is inserted (many women experience severe vaginal atrophy after menopause). They are much more likely to need a local anaesthetic than some-one younger. Some doctors say that usually ninety per cent of cases can be done with the patient awake, but if patients insist that they cannot tolerate much pain then doctors have to consider doing it under a general anaesthetic.

The NHS UK website says, ‘Some women feel none or only mild pain…but for others the pain can be severe. If you find it too uncomfortable, tell the doctor or nurse. They can stop the procedure at any time.

There are however too many women experiencing too much pain during this procedure, which is necessary for important diagnostic purposes. What is not necessary is to ignore women who experience such an amount of pain. If you have had some similar experience it is important for you to know that you are not alone, support is out there (links at the end of the article) and your voice needs to be heard.

So, don’t suffer in silence. This is something that needs to be changed, and you can make the difference

REFERENCES AND LINKS

Some testimony:
If you have experienced any of that and would you like your voice to be heard, below some links to get more informed and participate to the petition:
(there is also a closed group where you can discuss things in private.)

Please find below the link to the campaign’s ANONYMOUS survey. If you have had a painful hysteroscopy, please complete this survey. It will help to ensure future pain-free hysteroscopies. The more data collated, not only in the UK, the more info can be presented to MP Lyn Brown and the Health dept.