Hysteroscopy Explained
A closer look inside your womb
"A hysteroscopy allows doctors to look directly inside the uterus to identify problems that may affect fertility, cause abnormal bleeding or contribute to miscarriage."
What is a hysteroscopy?
A hysteroscopy is a procedure that allows a doctor to examine the inside of your uterus (womb) using a very thin camera called a hysteroscope.
The camera is gently passed through the vagina and cervix into the uterus.
Because the camera is so small, there are no cuts or incisions.
The doctor can see the lining of the uterus on a screen in real time.
Why is a hysteroscopy done?
A hysteroscopy may be recommended if you have:
Difficulty becoming pregnant
Recurrent miscarriage
Heavy or irregular periods
Bleeding after the menopause
Polyps seen on ultrasound
Fibroids affecting the uterine cavity
Abnormal bleeding between periods
A suspected uterine abnormality
An abnormal scan that needs further investigation
Unlike an ultrasound, a hysteroscopy allows the doctor to look directly inside the womb.
What can a hysteroscopy detect?
A hysteroscopy can identify problems such as:
Endometrial polyps
Submucosal fibroids (fibroids growing into the uterine cavity)
Scar tissue (Asherman's syndrome)
A uterine septum (a wall dividing the uterus)
Congenital abnormalities of the uterus
Thickened endometrium
Inflammation
Retained pregnancy tissue after miscarriage or childbirth
Occasionally, signs that require a biopsy to rule out cancer or precancerous changes
Can treatment be carried out at the same time?
Often, yes.
One of the advantages of hysteroscopy is that treatment can frequently be performed during the same procedure.
For example, the doctor may:
Remove a polyp
Remove a small fibroid
Cut away scar tissue
Divide a uterine septum
Take a biopsy of the uterine lining
This means that diagnosis and treatment can sometimes happen in a single appointment.
What happens during the procedure?
The exact process varies between hospitals.
Typically:
You lie on an examination couch.
A thin camera is passed through the cervix.
Sterile fluid is used to gently expand the uterus so the lining can be seen clearly.
The doctor carefully examines the uterine cavity.
If necessary, small instruments may be passed through the hysteroscope to perform treatment.
Many hysteroscopies are carried out in an outpatient clinic without a general anaesthetic.
Some procedures are performed under local or general anaesthetic, particularly if more extensive treatment is planned.
Does it hurt?
Experiences vary.
Some women describe:
✓ Mild period-like cramps.
Others experience:
✓ Moderate discomfort while the camera passes through the cervix.
If treatment is performed during the procedure, the discomfort may be greater.
Many women are able to return to normal activities later the same day.
How should I prepare?
Your hospital will give you specific instructions.
You may be advised to:
Take simple pain relief beforehand.
Eat and drink normally if no general anaesthetic is planned.
Arrange someone to drive you home if you're having sedation or a general anaesthetic.
Wearing comfortable clothing and bringing a sanitary pad can also be helpful, as light spotting afterwards is common.
What happens afterwards?
It is normal to experience:
Mild cramping
Light vaginal bleeding or spotting for a few days
A watery discharge
Most women recover quickly.
However, you should seek medical advice if you develop:
Heavy bleeding
Severe pain
A fever
Foul-smelling discharge
These could be signs of infection or another complication.
What are the risks?
Serious complications are uncommon, but can include:
Infection
Bleeding
Damage to the cervix
Very rarely, a small hole in the wall of the uterus (uterine perforation)
Your doctor will explain these risks before the procedure.
Questions you may wish to ask your doctor
Was the inside of my uterus normal?
Were any polyps or fibroids found?
Was there any scar tissue?
Was a biopsy taken?
Were any abnormalities treated today?
Will this affect my fertility?
Do I need any follow-up?
A gentle reminder
A hysteroscopy is one of the best ways to assess the inside of the uterus.
However, it cannot assess:
Whether your fallopian tubes are open
Egg quality
Ovulation
Sperm quality
Endometriosis outside the uterus
It is one important piece of the fertility puzzle, but not the whole picture.
Did you know?
Because a hysteroscopy allows doctors to look directly inside the uterus, it is often considered the gold standard for diagnosing problems within the uterine cavity.
Small abnormalities that may not be obvious on an ultrasound can sometimes be seen clearly during this procedure.
Georgina's Note ❤️
Infertility investigations often involve several different tests, and it can feel as though each appointment brings another unfamiliar word.
But every investigation has a purpose.
Some look at your hormones.
Some assess your ovaries.
Some check your fallopian tubes.
A hysteroscopy is simply the test that lets doctors look directly inside the womb itself.
If you know what each investigation is trying to discover, the process can feel a little less intimidating—and you become better equipped to ask the questions that matter.
Remember: you deserve to understand every test that's being offered, and every result that's explained.