A growing number of women are reporting significant pain during hysteroscopy procedures, routine examinations used to investigate womb conditions and remove fibroids or other abnormalities. Beth Harris underwent a hysteroscopy in February to remove a fibroid at her local hospital. Despite receiving local anesthetic, she experienced severe pain during the procedure and described feeling assaulted by the experience. Harris observed other patients undergoing the same procedure experiencing distress, with one becoming hysterical and another collapsing in the recovery room.
Hysteroscopies are classified by the NHS as high-volume, low-complexity procedures, with 71,000 performed in England alone in 2021. The procedures are commonly used to diagnose and treat heavy or unexplained bleeding, investigate infertility or recurrent miscarriage, and remove fibroids, polyps, or scar tissue. Guidelines from the National Institute for Health and Care Excellence made hysteroscopies the primary diagnostic tool for heavy or unexplained bleeding in 2018. The shift toward outpatient procedures accelerated through the 2000s and 2010s after clinical evidence demonstrated they were safe, faster, and more cost-effective than procedures requiring general anesthetic.
Hysteroscopy Action, a campaign group founded in 2010, has been advocating for 16 years for informed consent and expanded pain relief options for patients. The group calls for parity with colonoscopy procedures, noting that patients undergoing those examinations have access to local anesthesia, gas and air, conscious sedation, epidural, and general anesthetic options. Pain relief availability varies significantly across the country. In April, the Women’s Health Strategy included provisions for informed consent and pain relief choices for hysteroscopy patients, but campaign advocates report no subsequent implementation or progress.
Katharine Tylko, a founder member of Hysteroscopy Action, underwent a hysteroscopy 23 years ago under general anesthetic after being initially refused investigation by her GP. She was later diagnosed with late-stage womb cancer that took two years to identify. Through her cancer treatment, Tylko encountered many women traumatized by their hysteroscopy experiences, despite being told that only 2% of patients experienced problems with the procedures.
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