Hysteroscopy

What this procedure is

A hysteroscopy is a procedure that allows your clinician to look inside your uterus (womb). To do this, they use a hysteroscope, which is a thin, flexible tube with a light and a camera on the end. This tool sends images to a screen so your healthcare provider can see the lining of the uterus clearly.

Because the hysteroscope is inserted through the natural opening of the vagina and the cervix (the lower part of the uterus), there are usually no surgical cuts or incisions needed. This procedure can be used to help your clinician find the cause of a health issue or to treat a specific condition.

What it treats or fixes

Your clinician may recommend a hysteroscopy to help diagnose or treat several different conditions. Common reasons for the procedure include:

• Abnormal bleeding: Finding the cause of very heavy periods or bleeding that happens between periods or after menopause.
• Polyps and fibroids: Identifying and sometimes removing these noncancerous growths in the uterus.
• Scar tissue: Checking for or removing bands of scar tissue that may have formed inside the uterus.
• Fertility concerns: Looking for the cause of repeated miscarriages or difficulty becoming pregnant.
• IUD issues: Finding or removing an intrauterine device (IUD) that has moved out of place.

How common it is & where it's done

Hysteroscopy is a very common procedure used by gynecologists. It is often performed as an outpatient procedure, which means you usually do not need to stay in the hospital overnight. Most patients are able to go home the same day.

Depending on your needs and the type of hysteroscopy being done, it may take place in a clinician’s office or a hospital’s outpatient surgery center. Your healthcare team will talk with you about the best setting for your procedure and what type of anesthesia or numbing medicine might be used to keep you comfortable.

Recovery: What to Expect

Most patients are able to go home the same day as their procedure. You may feel some mild cramping or have light spotting for a few days, which is similar to a normal period. If gas was used to expand the uterus (the womb) so the clinician could see better, you might feel some temporary discomfort in your shoulders or upper body.

• Your clinician may suggest over-the-counter medicine to help with any mild discomfort.
• Most people can return to work and their normal daily activities within one to two days.
• Your care team will provide specific instructions on when it is safe to use tampons or have sex again.

Risks & Possible Complications

Hysteroscopy is generally a very safe procedure. While complications are not common, they can include infection, heavy bleeding, or a small injury to the wall of the uterus. In some cases, there may be a reaction to the fluid or gas used during the procedure.

It is helpful to know when to reach out for extra help. You should contact your clinician's office if you notice any of the following:

• A fever or chills.
• Severe pain in your abdomen that does not go away with rest.
• Vaginal bleeding that is much heavier than a typical period.

Outcomes & Long-Term Results

The long-term results of your procedure depend on why it was performed. If the clinician removed a polyp (a small, non-cancerous growth) or a fibroid, you may experience relief from symptoms like heavy bleeding or pelvic pain. If the procedure was done to find the cause of a symptom, the results will help your clinician create a treatment plan tailored to you.

Your clinician will usually schedule a follow-up visit to talk about the findings. This is a good time to ask questions about your results and any improvements you should expect to see in your health over the coming months.

Emotional Support & Reassurance

It is natural to feel a little nervous before any medical procedure. Hysteroscopy is a routine and effective way for your medical team to get a clear view of your health. This procedure is an important step toward finding answers and helping you feel your best.

Your healthcare team is dedicated to your comfort and safety. Do not hesitate to share your feelings or ask for more information at any point during your care. Knowing what to expect can help you feel more relaxed and prepared for the process.

Why doctors recommend it

A clinician may recommend a hysteroscopy to look inside the uterus (the womb) when a person has unusual symptoms. This procedure uses a thin, lighted tube called a hysteroscope. It allows the doctor to see the lining of the uterus clearly on a video screen.

Common reasons for this recommendation include:

• Heavy or long-lasting periods.
• Bleeding between periods or after menopause.
• Severe cramping or pelvic pain.
• Difficulty getting pregnant or repeated miscarriages.

Your clinician may suggest this if other tests, like an ultrasound, show something that needs a closer look. It is a helpful way to find small growths like polyps or fibroids (noncancerous lumps of tissue) that might be causing discomfort.

Urgent vs planned treatment

In most cases, a hysteroscopy is a planned procedure. It is often scheduled for a time when you are not having your period. This timing gives the doctor the clearest view of the uterine lining.

While it is rarely an emergency, your clinician might move more quickly if you have sudden, heavy bleeding that needs to be managed. Most of the time, it is part of a step-by-step plan to understand your health better.

The procedure can be used for two main purposes. A diagnostic hysteroscopy is done to find out what is wrong. An operative hysteroscopy means the doctor uses the same visit to treat a problem they find, such as removing a small growth.

Goals of treatment

The main goal of a hysteroscopy is to get clear answers. By looking directly at the inside of the uterus, your healthcare team can confirm a diagnosis or rule out certain conditions. This helps them create a treatment plan tailored to your needs.

Another goal is to provide relief from symptoms. If the procedure is used to remove polyps, fibroids, or scar tissue, the aim is to reduce heavy bleeding and lessen pelvic pain.

Success usually means that the cause of your symptoms has been identified or treated. For many people, this leads to more predictable cycles and improved comfort in their daily lives.

Who may benefit

A hysteroscopy is a procedure that allows your clinician to look inside the uterus (womb) using a thin, lighted tube called a hysteroscope. This tool helps find the cause of symptoms like very heavy periods, bleeding between periods, or bleeding that happens after menopause.

Your clinician may suggest this procedure to find and remove small, noncancerous growths like polyps or fibroids. It can also be used to find a "lost" intrauterine device (IUD) or to look for scar tissue that might be causing pain or trouble getting pregnant. In some cases, it is used to help diagnose the cause of repeated miscarriages.

When it may not be the right option

While this procedure is helpful for many, it may not be the right choice for everyone. Your clinician will likely avoid a hysteroscopy if you are currently pregnant, as the procedure could interfere with the pregnancy.

It is also usually not recommended if you have an active pelvic infection or inflammation of the uterus. Your care team will review your health history and current symptoms to make sure the procedure is the safest option for you at this time.

Questions to ask your care team

It is helpful to prepare a list of questions before your appointment to help you feel more comfortable. You might consider asking your care team the following:

• Why is a hysteroscopy recommended for my specific symptoms?
• Will this be done in the office or at a surgical center?
• What kind of anesthesia or numbing medicine will be used?
• How long will it take for me to return to my normal activities?
• Are there other tests or treatments we should try first?

In the procedure room

You will be asked to lie on an exam table with your feet in stirrups, much like a routine pelvic exam. The clinical team will clean the vaginal area with an antiseptic solution to help prevent infection and keep the area sterile.

High-level steps

Your clinician may gently widen, or dilate, the opening of the cervix to allow the hysteroscope to pass through. The hysteroscope is a thin, lighted tube with a camera that is inserted through the vagina and into the uterus. Because the scope goes through a natural opening, surgical incisions are usually not needed.

A liquid or gas is often flowed through the tube to expand the uterus. This helps the clinician see the uterine lining clearly on a monitor. If the procedure is being done to treat a condition, small tools may be used through the scope to remove growths or take a small tissue sample, known as a biopsy.

Anesthesia and pain control

The type of pain control used depends on the reason for the procedure and where it is performed. Your clinician may use:

• Local anesthesia: Medication is used to numb the cervix and surrounding area while you remain awake.
• Regional anesthesia: Medication is given through a needle in the back to numb you from the waist down.
• General anesthesia: You are given medicine to put you into a deep sleep so you do not feel anything during the procedure.

You may feel some pressure or mild cramping as the scope is moved, but the team works to keep you as comfortable as possible.

Monitoring and safety steps

While the procedure is happening, the clinical team will monitor your vital signs, such as your heart rate, blood pressure, and oxygen levels. They also carefully track the amount of fluid used to expand the uterus to ensure your safety throughout the process.

Immediately after the procedure

After the procedure is finished, you will be moved to a recovery area to rest. You may feel some mild cramping or notice light spotting or discharge for a few days. Your clinician will monitor you until the anesthesia wears off and you are ready to go home, which usually happens on the same day.

Typical procedure length

The length of the procedure can vary based on what needs to be done. A simple diagnostic check may take only 5 to 15 minutes. If the clinician is removing a growth or performing a repair, the process may take 30 minutes or longer.

Common approaches (open vs minimally invasive)

Hysteroscopy is considered a minimally invasive procedure. Unlike "open" surgery, it does not require any cuts (incisions) on your skin or belly. Instead, the doctor uses a thin, lighted tube called a hysteroscope.

Your clinician inserts this tool through the vagina to reach the uterus. This approach allows the healthcare team to examine the cervix and the inside of the uterus without the need for major abdominal surgery.

Partial vs total

Not always applicable. The terms "partial" and "total" are typically used to describe surgeries where the uterus is removed (hysterectomy). They do not generally apply to hysteroscopy, which is a procedure used to look inside the uterus rather than remove it.

Instead of partial or total, this procedure is usually categorized by its purpose:

• Diagnostic hysteroscopy: This is used only to look at the uterus to find the cause of a problem.
• Operative hysteroscopy: This is used to treat a problem found during the exam. Small tools are passed through the hysteroscope to correct the issue.

Revision or repeat procedures

Your clinician may recommend a hysteroscopy to investigate ongoing issues, such as the cause of repeated miscarriages. It allows the doctor to see the shape of the uterus and check for any abnormalities.

This procedure can also be used in combination with other treatments. For example, it may be done alongside a dilation and curettage (D&C) or laparoscopy to ensure a thorough examination or to follow up on a previous concern.

Tests and imaging that may be done

Your healthcare provider will likely start by explaining the procedure and asking about your medical history. You may have a physical exam to check your general health before the hysteroscopy. Depending on your specific situation, your clinician may also order blood tests or other diagnostic tests.

Because this procedure is often best done after your period but before ovulation, let your provider know if you are pregnant or think you might be. This helps the team ensure the timing is safe and appropriate for you.

Medication adjustments

It is important to tell your healthcare provider about everything you take. This includes prescription medicines, over-the-counter drugs, and herbal supplements. Be sure to mention if you have a history of bleeding disorders or if you take blood-thinning medicines (anticoagulants), aspirin, or other drugs that affect blood clotting.

Your provider will let you know if you need to change your routine. Only stop taking medicines if your clinician instructs you to do so. Additionally, tell your team if you are sensitive or allergic to any medicines, latex, tape, iodine, or anesthesia.

Day-before and day-of instructions

Your clinician will give you specific instructions based on the type of anesthesia or sedation being used. Common preparations include:

• Paperwork: You will be asked to sign a consent form. Read the form carefully and ask questions if anything is unclear.
• Fasting: If you are receiving a sedative or general anesthesia, you will likely need to stop eating and drinking for a certain time before the procedure. Follow these directions closely.
• Clothing: Dress in clothes that are easy to remove or allow access, as you will likely change into a gown.
• Transportation: If you are given a sedative or general anesthesia, you will not be able to drive yourself home. Arrange for a friend or family member to drive you.

General surgical risks

As with any surgical procedure, complications can occur. While many people undergo hysteroscopy without major issues, it is helpful to understand the general risks associated with surgery. Your healthcare team works to minimize these risks and keep you safe.

• Infection: There is a possibility of developing an infection after the procedure.
• Bleeding: You may experience bleeding during or after the surgery.
• Anesthesia risks: If medication is used to help you sleep or relax (anesthesia), there are potential risks related to how your body reacts to it.

Procedure-specific complications

There are also risks specific to the tools and methods used during a hysteroscopy. Your clinician will be careful to avoid these issues while examining the uterus.

• Perforation: Rarely, a hole (perforation) may be made in the wall of the uterus.
• Cervical injury: The cervix, which is the opening to the uterus, may tear.
• Fluid or gas problems: Issues can arise involving the fluid or gas used to expand the uterus for better viewing.
• Organ damage: In some cases, there may be damage to nearby organs.

How complications are treated

Your healthcare provider assesses your personal risks before the procedure begins. Certain factors, such as pelvic inflammatory disease, vaginal discharge, or an inflamed cervix, can interfere with the procedure. Your clinician will check for these conditions to decide if the procedure can proceed safely.

Because risks can vary depending on your specific medical condition, it is important to discuss any concerns with your healthcare provider prior to the procedure. They can explain how they monitor for complications and the steps they take to manage them if they occur.

Pain control medicines

Your clinician will tailor your pain management based on the type of hysteroscopy you are having. You may receive a sedative, which is a medicine used to help you feel relaxed and calm before the procedure begins.

Different types of anesthesia may be used to ensure your comfort:

• Local anesthesia: This numbs the specific area being treated while you stay awake.
• Regional anesthesia: This numbs a larger area of the body, such as from the waist down.
• General anesthesia: This medicine puts you into a deep sleep so you do not feel anything during the procedure.

In some cases, your healthcare provider may suggest taking a simple pain reliever shortly before the appointment to help manage mild cramping.

Antibiotics

Your healthcare provider will determine if you need antibiotics based on your specific health needs and the type of procedure being performed. These medicines are sometimes used to help prevent the risk of infection.

It is important to share your full health history with your care team. Be sure to mention any known drug allergies or past reactions to medications to ensure the safest choice is made for you. Your clinician will provide instructions if you need to take any medicine before or after your visit.

Blood thinners and clot prevention

Before your procedure, your clinician will review all the medications and supplements you currently take. They will provide specific instructions on whether you need to temporarily stop taking certain medicines, such as blood thinners.

Managing these medications is a standard safety step to help reduce the risk of bleeding during and after the hysteroscopy. Your care team will tell you exactly when to pause your medicine and when it is safe to start taking it again. Never stop taking prescribed medications without first consulting your healthcare provider.

Emergency warning signs

While serious complications are rare, it is important to know when to get help right away. According to Johns Hopkins Medicine, you should seek medical attention immediately if you experience:

• Severe abdominal pain: Pain in your belly that is very strong or does not get better with pain medication.
• Heavy vaginal bleeding: Bleeding that is much heavier than a normal period or does not stop.

Call your surgeon or clinic if…

Contact your healthcare provider if you notice signs of a possible infection or other issues during your recovery. Your clinician may want to check on you if you have:

• Fever: A high temperature can be a sign of infection.
• Abnormal discharge: Vaginal discharge that is heavy or different from what you were told to expect.

Expected vs concerning symptoms

Knowing what is normal helps you stay calm during recovery. Most people experience some discomfort as they heal.

• Expected: It is normal to have some cramping and light vaginal bleeding for a day or two after the procedure. You may also feel gas pains or shoulder pain if gas was used during the surgery.
• Concerning: You should reach out for help if the bleeding becomes heavy, if the pain is severe, or if you develop a fever.

Non-surgical treatments

Before suggesting a hysteroscopy, your clinician may recommend non-surgical ways to manage your symptoms. For many people, medications are the first step. These can include hormone therapies, such as birth control pills or progestin (a hormone that helps regulate the menstrual cycle), which help thin the uterine lining and reduce heavy bleeding.

Other options might include:

• Pain relievers: Over-the-counter medicines to help with cramping or pelvic discomfort.
• Iron supplements: To help if heavy bleeding has caused low iron levels, also known as anemia.
• Hormonal devices: Such as an intrauterine device (IUD) that stays in the uterus and releases hormones to manage the lining and reduce bleeding.

Watchful waiting

In some cases, you and your clinician may decide to simply monitor the situation. This is often called "watchful waiting." This approach is common if your symptoms are mild or if a small growth, like a polyp (a small, non-cancerous growth on the lining of the uterus), is unlikely to cause health problems.

During this time, you will have regular check-ups to see if your symptoms change or if the condition improves on its own. This allows you to avoid a procedure while ensuring your health is still being managed by a professional. If symptoms stay the same or get better, surgery may not be needed at all.

When surgery becomes the best option

A hysteroscopy may become the best choice if non-surgical treatments do not provide enough relief. If heavy bleeding or pelvic pain continues to interfere with your daily life, your clinician may suggest the procedure to find the cause or treat the issue directly.

Surgery is also often recommended when a diagnosis is needed. For example, if your clinician needs to perform a biopsy (taking a small tissue sample for testing) or remove a growth like a fibroid (a non-cancerous growth in the muscle of the uterus) that is causing problems. It is also a common step if you are having trouble getting pregnant, as it allows the doctor to look for and fix physical issues inside the uterus that might be preventing pregnancy.

Hospital services that commonly perform this surgery

Hysteroscopy is a common procedure used to look inside the uterus (womb). It is most often performed in specialized departments within a hospital or a dedicated surgical center. You will likely visit the Gynecology or Women’s Health department for your care.

Many facilities offer this as an outpatient procedure, which means you can usually go home the same day. Depending on your specific needs, your clinician may perform the procedure in a hospital operating room or a specialized procedure room in their office.

Patient resources and support services

Most hospitals provide resources to help you feel prepared and comfortable before and after your procedure. These services are designed to guide you through the process and answer any questions you may have.

• Educational Materials: Many centers provide brochures or videos that explain the procedure and what to expect during your recovery.
• Financial Counseling: Hospitals often have staff available to help you understand your insurance coverage and any potential costs.
• Nurse Navigators: Some facilities offer specialized nurses who can help coordinate your appointments and explain your care plan.
• Language Services: Interpreters are usually available if you prefer to discuss your health in a language other than English.

Questions for choosing where to have surgery

Choosing the right place for your procedure can help you feel more at ease. You may want to ask your clinician or the facility the following questions to help you make a decision:

• Is this facility accredited and experienced in performing hysteroscopies?
• What types of anesthesia or pain management options are available for this procedure?
• Will the procedure be done in an office setting or a hospital operating room?
• Does the facility accept my specific health insurance plan?
• What kind of support is available if I have questions during my recovery at home?
• How does the facility handle follow-up care or unexpected concerns after the procedure?

Conditions commonly treated by this procedure

A hysteroscopy is a procedure where a clinician uses a thin, lighted tube to look inside the uterus (womb). This helps them find and sometimes treat certain health issues. Common conditions include polyps, which are small, soft growths on the lining of the uterus, and fibroids, which are firm, non-cancerous growths.

Your clinician may also use this procedure to find adhesions. These are bands of scar tissue that can cause the walls of the uterus to stick together. Another condition is a uterine septum, which is a wall of tissue inside the uterus that has been there since birth. In some cases, a hysteroscopy is used to find the cause of repeated miscarriages or to locate a displaced intrauterine device (IUD).

Related symptoms people search for

Many people are referred for a hysteroscopy because they are experiencing changes in their menstrual cycle. This may include periods that are much heavier than usual or bleeding that happens between regular periods. It is also commonly used to check on bleeding that occurs after menopause.

Other symptoms that might lead to this procedure include:

• Pelvic pain or cramping that does not go away.
• Difficulty becoming pregnant, which is often called infertility.
• Having two or more miscarriages in a row.

If you have these symptoms, your clinician may recommend a hysteroscopy to get a better look at what is happening inside. This procedure allows them to see the shape of the uterus and the health of its lining without making large incisions.

Evidence overview

Hysteroscopy is a standard medical procedure used to examine the inside of the uterus (womb). It is widely accepted by medical professionals as an effective way to diagnose and treat various gynecological conditions. Clinicians often recommend it to investigate symptoms such as heavy periods, bleeding after menopause, or repeated miscarriages.

Because the procedure involves inserting a thin, lighted tube through the natural opening of the cervix, it does not require incisions (cuts) on the skin. This approach is supported by evidence showing it generally allows for a faster recovery and less pain compared to more invasive surgeries. It serves a dual purpose: it helps doctors see the problem and, in many cases, allows them to treat issues—such as removing polyps, fibroids, or scar tissue—at the same time.

Safety notes and individualized care

Hysteroscopy is generally considered safe, but like all medical procedures, it carries some risks. Your healthcare provider will review your medical history to ensure this is the right option for you. Possible complications are rare but can include:

• Infection: Bacteria entering the uterus.
• Bleeding: Heavier bleeding than expected during or after the procedure.
• Injury: Accidental tearing or perforation (poking a hole) in the wall of the uterus or damage to the cervix.
• Fluid issues: Reactions to the liquid or gas used to expand the uterus so the doctor can see clearly.
• Anesthesia risks: Side effects from the medication used to prevent pain.

Your care plan will be adjusted to your specific needs. For a simple look inside (diagnostic hysteroscopy), the procedure might take place in a doctor’s office with local numbing medicine. If you need a growth removed (operative hysteroscopy), it may be done in a hospital setting with general anesthesia to keep you asleep. After the procedure, mild cramping and light spotting are normal. However, you should contact your clinician immediately if you experience fever, severe abdominal pain, or heavy bleeding.

Sources used

The information provided in this section is based on patient education materials from major academic medical centers and established healthcare organizations specializing in women's health and gynecological surgery.