Hysteroscopy

A test that uses a thin telescope passed through the vagina and cervix to look inside the womb, and sometimes to take a sample or remove small growths.

✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review

In short

A hysteroscopy uses a thin telescope to look inside the womb, often to investigate abnormal bleeding, and can take a sample or remove small polyps at the same time.
Pain varies a lot: many women find it uncomfortable but manageable, while around a third report severe pain, so you should be offered choices and be able to stop at any time.
It can be done with no anaesthetic, local anaesthetic, sedation or a general anaesthetic; each has trade-offs to discuss beforehand.
Serious problems such as a hole in the womb are uncommon, but you should know the warning signs and who to contact.

A plain-English summary. The detail — including risks and recovery — is below.

At a glance

TypeEndoscopy (telescope examination of the womb)

AnaestheticOften none or local anaesthetic; sometimes sedation or general anaesthetic

How long it takesAbout 10 to 15 minutes for a look; longer if treatment is done

Hospital stayUsually outpatient; day case if done under general anaesthetic

Time off workOften none to a day; a little longer after a general anaesthetic

When you'll see resultsSome findings are explained on the day; biopsy results take a week or two

On the NHS?Widely available on the NHS when clinically needed, and also offered privately

A general guide. Your specialist will give you advice for your situation.

Best fit

Gives a direct, clear view of the inside of the womb that scans alone cannot provide.

Pause if

If there is any chance you are pregnant, the test is not carried out.

Main recovery point

You may feel period-type cramps and some pressure, and occasionally faint or sick. Tell the team how you feel; the test can be slowed or stopped.

Good aftercare

Clear written advice on normal bleeding and cramping, and the warning signs of infection or perforation.

During the test

You may feel period-type cramps and some pressure, and occasionally faint or sick. Tell the team how you feel; the...

First few hours

Cramping and light bleeding are normal. After an awake test you can usually leave soon afterwards; after sedation...

First 1 to 2 days

Mild cramps and spotting may continue. Most people return to normal activities, though you may prefer to take it...

First week

Spotting or light bleeding can last up to about a week. Use pads rather than tampons, and avoid sex until any...

Medical line illustration of the uterus and hysteroscopy pathway for Hysteroscopy. — Illustration only - not a diagnosis, medical advice or a promise of result. Your anatomy and treatment plan may differ. Vuemedics does not publish before-and-after photos.

What is a hysteroscopy?

A hysteroscopy is a test that lets a gynaecologist look inside your womb using a very thin telescope with a camera, called a hysteroscope. It is passed gently through the vagina and the neck of the womb (cervix), so there are no cuts.

It is used to find the cause of problems such as heavy, irregular or post-menopausal bleeding, to look at polyps or fibroids seen on a scan, to investigate fertility problems or miscarriage, and sometimes to remove a coil with missing threads. Salt water is used to gently open up the womb so the lining can be seen clearly.

Many hysteroscopies are 'see-and-treat': a small sample (biopsy) can be taken, or small polyps removed, during the same appointment. It tells you about the inside of the womb, but it is not a test for ovarian problems and does not replace a scan.

It is important to know that an outpatient hysteroscopy can be uncomfortable, and for some women painful, and that you can ask for it to be stopped at any time.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Outpatient hysteroscopy

Done while you are awake in a clinic, usually with no anaesthetic or a local anaesthetic, sometimes with gas and air. Quick and avoids a general anaesthetic, but can be uncomfortable or painful.

Diagnostic hysteroscopy

A look inside the womb to find a cause for symptoms, often with a small biopsy of the lining. No tissue is cut away beyond the sample.

Operative (see-and-treat) hysteroscopy

Small polyps, fibroids or scar tissue are removed, or a lost coil retrieved, during the same procedure. May take a little longer and is sometimes done under general anaesthetic.

Hysteroscopy under general anaesthetic or sedation

Done asleep or sedated in theatre as a day case, for people who prefer it, where more treatment is planned, or where an awake test was too painful or not possible.

Awake vs asleep hysteroscopy

	Outpatient (awake)	General anaesthetic
Anaesthetic	None or local	Asleep
Setting	Clinic	Theatre, day case
Recovery	Often same-day	A little longer
Discomfort during	Can be painful for some	None during the test
Hole in womb risk	Lower	Slightly higher

Neither option is automatically 'better'. Your choice depends on your pain expectations, what treatment is planned, your medical history and how you feel about a general anaesthetic.

Preparing for your procedure

Tell the clinic if there is any chance you could be pregnant, as the test is not done in pregnancy.
Discuss your pain-relief options in advance, including local anaesthetic, gas and air, sedation or a general anaesthetic.
Consider taking ibuprofen or paracetamol about an hour before an outpatient appointment, if your clinician agrees.
Arrange for someone to take you home and stay with you if you are having sedation or a general anaesthetic.
Bring sanitary pads, as light bleeding afterwards is common; avoid tampons.
Mention any bleeding disorders or blood-thinning medicines, and any history of a difficult smear or cervix problems.
Ask whether a biopsy or removal of a polyp is likely, so you know what to expect on the day.
Eat and drink normally for an awake test, but follow fasting instructions if you are having sedation or a general anaesthetic.

What happens

For an outpatient hysteroscopy you lie back with your legs supported, much like for a smear test. The gynaecologist may use a speculum to see the cervix, then passes the thin hysteroscope through the cervix into the womb. Salt water is run through to gently open the womb so the lining can be seen on a screen.

If needed, a small sample of the lining is taken, or a small polyp removed, using fine instruments passed alongside the telescope. A look usually takes about 10 to 15 minutes; treatment takes longer. You may feel period-type cramps, and some women feel faint or sick.

You can ask for the test to be paused or stopped at any time. If the cervix is tightly closed or the test is too painful, it may be stopped and rebooked under sedation or a general anaesthetic.

Under general anaesthetic, the same steps are done while you are asleep in theatre as a day case, and you wake up in a recovery area.

Is this procedure right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

May not be suitable if…

If there is any chance you are pregnant, the test is not carried out.
When the main concern is the ovaries or tubes, which a hysteroscopy does not assess.
During an active pelvic infection, until it has been treated.
When a scan alone would answer the question, making the telescope unnecessary.

Delay or rearrange if…

You might be pregnant, or have an untreated pelvic or sexually transmitted infection.
You are bleeding very heavily at the time, which can make the view poor.
Blood-thinning medicines need to be reviewed first.
You have not had a chance to discuss and choose your pain relief or anaesthetic.

Alternatives to discuss

A pelvic or transvaginal ultrasound, which looks at the womb structure and the ovaries.
A saline-infusion scan (sonohysterography) to look at the womb lining.
An endometrial biopsy taken in clinic without a full hysteroscopy in some cases.
Watchful waiting or medical treatment for symptoms where appropriate.
Doing the procedure under general anaesthetic instead of awake.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

What matters most to me?

Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.

What are all my options?

Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.

What would make me pause?

Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.

What happens if I do nothing today?

For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.

Comfort, sedation or contrast choices

If local anaesthetic, sedation, contrast or pain relief is used, ask what is planned, why, and what it means afterwards.

No anaesthetic

Common for a quick outpatient look, often with simple painkillers taken about an hour beforehand.

Local anaesthetic

An injection or gel to numb the cervix, which can help if the cervix needs to be opened or a biopsy taken.

Inhaled pain relief (gas and air)

Entonox or similar can be used during an awake procedure to take the edge off discomfort.

Sedation or general anaesthetic

Used in theatre as a day case where more treatment is planned, an awake test was too painful, or you prefer to be asleep; needs fasting and someone to take you home.

Benefits

Gives a direct, clear view of the inside of the womb that scans alone cannot provide.
Can find the cause of abnormal bleeding, such as polyps, fibroids or lining changes.
Allows a biopsy to check the womb lining, including to rule out serious causes.
Lets small polyps or fibroids be removed, or a lost coil retrieved, often in the same visit.
Can be done awake and quickly, avoiding a general anaesthetic for many people.

Risks & complications

More common

Period-type cramping during and after the test
Light bleeding or spotting for a few days
Feeling faint, dizzy or sick during or just after the procedure
Pain that, for some women, is severe rather than mild

Less common

The test being unsuccessful or abandoned, often because the cervix is too tightly closed
Infection of the womb, sometimes needing antibiotics
Heavier or more prolonged bleeding than expected

Rare but serious

A small hole made in the wall of the womb (perforation), which may need observation or surgery
Damage to nearby structures such as the bladder or bowel if a perforation occurs
Problems related to sedation or general anaesthetic, if used

The two things to weigh most are pain and the small risk of a hole in the womb (perforation). Pain is unpredictable: many women cope well, but a significant minority find an awake hysteroscopy very painful, so ask what pain relief is available and remember you can stop at any time. Perforation is uncommon, slightly more likely when tissue is being removed and during a general-anaesthetic procedure; ask your clinician what would happen if it occurred.

Published figures to discuss

Hysteroscopy is generally low-risk, but pain during an awake procedure is hard to predict and serious complications, although uncommon, do happen. The figures below come from UK guidance and studies and are indicative rather than exact for any one person.

Figure	Reported range	How to interpret it	Source / confidence
Severe pain during outpatient hysteroscopy	Around a third of women report pain above 7 out of 10 in some studies	Pain varies widely; you should be offered choices and be able to stop the test.	Guide sourcesClinical context
Infection of the womb	Uncommon; reported in less than 3 in 100 women	Usually treated with antibiotics; report fever or smelly discharge.	Assessment of pain and complications of local-anaesthetic hysteroscopy — PMCncbi.nlm.nih.govSource-linked context
Perforation (a hole in the womb)	Uncommon; under about 1 in 200 diagnostic procedures, and a little higher when tissue is removed	May need observation or surgery; risk is slightly higher under general anaesthetic.	Assessment of pain and complications of local-anaesthetic hysteroscopy — PMCncbi.nlm.nih.govPublished figure
Unsuccessful or abandoned procedure	Happens in a minority, often when the cervix is tightly closed or scarred	Can usually be rebooked under sedation or general anaesthetic.	Guide sourcesClinical context

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

Most people recover quickly from a hysteroscopy. After an outpatient test many feel able to go back to normal activities the same day; after a general anaesthetic you will need the rest of the day to recover and someone to take you home.

During the test

You may feel period-type cramps and some pressure, and occasionally faint or sick. Tell the team how you feel; the test can be slowed or stopped.

First few hours

Cramping and light bleeding are normal. After an awake test you can usually leave soon afterwards; after sedation or general anaesthetic you rest in recovery first.

First 1 to 2 days

Mild cramps and spotting may continue. Most people return to normal activities, though you may prefer to take it easy for a day.

First week

Spotting or light bleeding can last up to about a week. Use pads rather than tampons, and avoid sex until any bleeding has settled.

1 to 2 weeks

If a biopsy was taken, the results usually come back within a week or two, with a plan explained at follow-up or by letter.

What's normal — and not a worry

Period-type cramping for a day or so
Light bleeding or brown spotting for up to about a week
Feeling a little tired, especially after a general anaesthetic
Mild discomfort that eases with simple painkillers

Aftercare

Use simple pain relief such as paracetamol or ibuprofen for cramps if you can take them.
Use sanitary pads rather than tampons while you have any bleeding.
Avoid sex until bleeding and pain have settled, to lower the risk of infection.
You can usually shower as normal; follow any specific advice from your clinic.
Do not drive or make important decisions for 24 hours if you had sedation or a general anaesthetic.
Rest for the remainder of the day after a general anaesthetic and have someone with you overnight.
Look out for signs of infection or heavy bleeding and know who to contact.
Note when and how you will get any biopsy results.

Before your procedure

Sanitary pads packed
Simple painkillers at home
Someone to take you home if you are having sedation or a general anaesthetic
Time booked off if you prefer to rest for a day
Clinic contact number for problems saved
A note of when biopsy results are due

⚠ Get urgent help if…

Heavy vaginal bleeding, for example soaking pads quickly or passing large clots
Severe or worsening tummy pain that is not eased by painkillers
A high temperature, shivering or feeling generally very unwell
Smelly or discoloured vaginal discharge (a sign of infection)
Feeling faint, breathless or unwell after going home
Being unable to pass urine after the procedure

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your specialist gives you.

Results & realistic expectations

Sometimes the gynaecologist can tell you what they saw straight away, such as a polyp or a normal-looking lining. If a biopsy was taken, the tissue is examined under a microscope and the result usually comes back within a week or two.

A normal hysteroscopy is reassuring about the inside of the womb, but it does not check the ovaries or tubes and cannot rule out every problem elsewhere. Your clinician will explain what the findings mean for you and whether any treatment or further tests are needed.

How long it lasts

A hysteroscopy is a snapshot of the womb at one point in time. If symptoms such as abnormal bleeding return or change, the test may need to be repeated, or different investigations arranged. Any treatment done, such as removing a polyp, does not guarantee that new polyps or symptoms will never come back.

Related tests, treatments or support

A hysteroscopy is often arranged alongside a pelvic ultrasound, which looks at the ovaries and the structure of the womb, and sometimes with a biopsy of the lining. In fertility care it may be combined with other tests of the tubes and ovaries. Your clinician will explain how the results fit together.

Follow-up & long-term care

If a biopsy was taken, you will usually get the result within a week or two, either at a follow-up appointment or by letter, with a clear plan. If a polyp was removed or a coil retrieved, you should be told whether anything further is needed. Report any infection or heavy-bleeding symptoms before your follow-up.

Repeat, follow-on and what comes next

If the test cannot be completed awake, it may need to be repeated under general anaesthetic.
A biopsy can occasionally be inconclusive and need to be repeated or followed by further tests.
Removing a polyp does not stop new polyps or symptoms returning later.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

Clear written advice on normal bleeding and cramping, and the warning signs of infection or perforation.
A named contact and out-of-hours number for problems after the test.
A definite plan and timescale for receiving any biopsy results.
A follow-up appointment or letter explaining the findings and any next steps.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

Whether the procedure is a diagnostic look only or includes removing a polyp or fibroid.
The anaesthetic chosen, especially if sedation or a general anaesthetic is used in theatre.
The facility or theatre fee, which is higher for a general-anaesthetic day case.
Whether a biopsy is taken and the laboratory fee to analyse it.
The consultant's fee and any follow-up appointment to discuss results.
Whether a pelvic ultrasound or other tests are done at the same time.

Make sure your written quote includes

Whether the price covers a diagnostic test only or also any treatment such as polyp removal.
The anaesthetic and, if relevant, the theatre or day-case facility fee.
The cost of any biopsy and its laboratory analysis.
The follow-up consultation to discuss results.
What happens to the cost if the test cannot be completed and has to be repeated under anaesthetic.
The cancellation policy and any charge if a complication needs further care.

On the NHS? Hysteroscopy is widely available on the NHS when clinically indicated; private access is mainly used for speed, choice of anaesthetic, or seeing a particular specialist.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Choosing a specialist safely

Check the specialist is on the GMC Specialist Register for this area.
Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Questions to ask your medical professional

Take this to your consultation. A good specialist will welcome every one of these.

What pain relief can I have, and what happens if I find it too painful?
Are you likely to take a biopsy or remove anything during the same appointment?
Would an awake test or a general anaesthetic suit me better, given my history?
What will this test change about my diagnosis or treatment?
What happens if the result is normal, abnormal or unclear?
How and when will I get my results, and who do I contact if I have problems?
Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
Will you be the specialist who carries out my procedure, and who looks after me afterwards?
What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
What does a realistic result look like — and what can this procedure not achieve?
What are my options, including waiting, doing nothing for now, or choosing a different approach?
Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Frequently asked questions

Is a hysteroscopy painful?

It varies a lot. Many women find an outpatient hysteroscopy uncomfortable but bearable, like strong period cramps, while around a third report severe pain. You should be offered pain-relief choices and can ask for it to be stopped at any time.

Will I be awake?

Often yes, for an outpatient test. But you can usually choose local anaesthetic, gas and air, sedation, or a general anaesthetic, depending on the clinic, what is planned and how you feel.

How long does it take?

A look inside the womb usually takes about 10 to 15 minutes. It takes longer if a polyp or fibroid is being removed.

When will I get my results?

Some findings are explained on the day. If a biopsy was taken, the laboratory result usually comes back within a week or two, with a plan at follow-up or by letter.

Can I go back to work afterwards?

After an awake test many people return to normal activities the same day. After sedation or a general anaesthetic you should rest for the day and not drive for 24 hours.

What if it is too painful or can't be completed?

You can ask for it to be stopped at any time. If the cervix is too tightly closed or the test is too painful, it can be rebooked under sedation or a general anaesthetic.

Find a verified specialist for hysteroscopy

Every consultant is GMC-checked and independently reviewed. Search by postcode and distance, or switch to a map. Ordered by rating, relevance and recency — never by who pays.

No verified consultants list this procedure yet — browse the full directory.

See all specialists for hysteroscopy →

How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: RCOG — Outpatient hysteroscopy (patient information) NHS — Hysteroscopy NICE — Heavy menstrual bleeding: assessment and management (NG88) Assessment of pain and complications of local-anaesthetic hysteroscopy — PMC

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.