Hysteroscopy pain: why routine womb exams leave some women in agony

Hysteroscopy is classified in medical literature as a 'low complexity' procedure. Yet a growing number of women who have undergone it describe their experience in starkly different terms: unbearable pain, dismissed complaints, and a feeling of losing control during the procedure.

The procedure involves passing a thin, camera-equipped instrument through the cervix into the womb to diagnose problems or remove growths such as fibroids. A saline solution is used to widen the uterus — a step many patients report as the most painful part.

More than 70,000 hysteroscopies are carried out every year in England. The NHS classifies the procedure as routine and 'low complexity,' a designation that often results in only mild pain relief, such as paracetamol or ibuprofen, being recommended rather than general anesthesia.

But a growing body of patient accounts suggests that classification doesn't always match the lived experience. Some patients say they weren't told they had the right to pause the procedure or request additional pain relief when they spoke up about discomfort; others say their complaints were not taken seriously by medical staff.

Experts say the gap has several sources. Pain perception varies significantly from person to person, and the uterus and cervix are richly supplied with nerve endings, meaning a standardized 'low complexity' protocol may not suit everyone. Research into pain management in women's health has also historically received less funding and attention than in other areas of medicine.

Healthcare workers acknowledge that resource pressure plays a role too. General anesthesia requires additional staff, equipment, and a hospital bed, making performing the procedure under local anesthesia in a clinic setting more 'efficient' for both patient throughput and the system — an efficiency that, for some patients, comes at the cost of significant pain.

Patient advocacy groups argue the fix isn't complicated: clear information about pain-relief options before the procedure, an explicit understanding that patients can say 'stop' at any point, and taking pain complaints seriously. These three steps could transform the experience with almost no added cost.

Some NHS trusts have responded to this feedback by reviewing their protocols, strengthening informed consent processes, and offering patients more choice in pain management. Critics, however, say the change has been applied inconsistently across the country.

The issue is part of a broader conversation in women's health: research has repeatedly documented that pain reported by women tends to be taken less seriously than pain reported by men. The hysteroscopy case stands out as a concrete, measurable example of that pattern.

Experts stress that the fix isn't complex technology, but a shift in the culture of listening — the idea that a patient saying 'this hurts' should be enough, on its own, to pause the procedure or change the approach.