Hysteroscopy: What You Need to Know Before Your Procedure

If you're experiencing abnormal uterine bleeding or bleeding after menopause, it's natural to feel concerned about what might be causing it. Following your consultation, your doctor may recommend a hysteroscopy to help identify the underlying cause.

It's understandable if you have questions about what the procedure involves and are worried about what to expect. Let's take a closer look at hysteroscopy to help you make an informed decision and feel prepared for the procedure.

What is hysteroscopy?

Hysteroscopy is a medical procedure where a thin, telescope-like instrument called a hysteroscope is inserted into the uterus (womb) via the cervix (the womb's neck). This allows your doctors to examine the inside of the uterus (uterine cavity) in real time for diagnostic or operative (treatment) purposes.

A diagnostic hysteroscopy can help identify any structural irregularities in your womb that may be causing abnormal bleeding. It can also confirm results from other tests, such as pelvis ultrasound or HSG tests.

On the other hand, an operative hysteroscopy helps treat abnormalities detected during diagnostic hysteroscopy. During an operative hysteroscopy, your doctor will use specialised instruments to remove any detected abnormalities and may perform both diagnostic and operative procedures simultaneously, thus avoiding the need for a second hysteroscopy.

When is hysteroscopy recommended?

Since hysteroscopy lets your doctor see inside your womb and focus on any areas that look suspicious, they may perform a hysteroscopy to diagnose and treat the following uterine conditions:

• Identification of uterine cancer

• Investigation of fertility issues

• Diagnosis and removal of placental tissue after birth

• Diagnosis of the cause of repeated miscarriages or fertility problems

• Locating and removing contraceptive devices such as intrauterine devices (IUDs)

• Evaluation and treatment of abnormal uterine bleeding and other uterine anomalies

• Finding and removing polyps, fibroids or adhesions (bands of scar tissue that can form in your uterus and may affect your menstrual cycle)

• Helping to determine whether you have a uterine septum, a malformation (defect) of the uterus that’s present from birth.

If you're experiencing abnormal bleeding after menopause or heavy irregular periods that may require a hysteroscopy, schedule an appointment with Thomson Women’s Clinic. Our obstetrician and gynaecologist (O&G) specialists understand your concerns and will help to ensure you feel comfortable and informed throughout your care.

What to prepare before your procedure

Before your hysteroscopy appointment, there are several simple steps to help ensure the procedure goes smoothly:

• Empty your bladder before the procedure begins to ensure your comfort during the examination.

• Consult your doctor about the pain management options available to you beforehand, as sedatives, painkillers or local anaesthesia can be used to minimise any discomfort.

• Wear comfortable, loose-fitting clothes that are simple to remove, as you will need to undress from the waist down.

• If you are still menstruating, your doctor may recommend scheduling the procedure for after your period, when the uterine lining is thinner and easier to examine.

What to expect during your hysteroscopy

Understanding what happens during the procedure can help you feel more prepared and at ease:

• Positioning and initial preparation:

  • You'll be asked to lie on the examination table with your feet in stirrups.

• Inserting the hysteroscope:

  • Your doctor will gently insert a speculum in your vagina to clean it and visualise your cervix clearly. If needed, your cervix may be gently dilated to allow the hysteroscope to pass through comfortably.

  • Thereafter, the hysteroscope is carefully moved through your cervix and into your uterus.

• Creating a clear view:

  • To help your doctor see the uterine walls more clearly, a sterile saline solution is gently injected into your uterus through the hysteroscope.

  • This fluid expands your uterus slightly, allowing detailed examination of the uterine walls and any abnormalities.

• Visual examination:

  • The hysteroscope transmits real-time images to a monitor, enabling your doctor to thoroughly inspect your entire uterine cavity, including the endometrium (the inner lining of the womb) and the openings of your fallopian tubes.

In addition, they may perform further procedures during the process, such as:

• Taking tissue samples (endometrial biopsy) for laboratory analysis

• Removing polyps or displaced intrauterine devices

• Treating fibroids, uterine septums, or scar tissue

• Performing endometrial ablation, if necessary, to treat heavy bleeding

Once the examination and any necessary treatments are finished, your doctor will carefully remove the hysteroscope and allow the saline solution to drain naturally. The procedure usually takes around 15 minutes but can take longer if any tissue samples are taken or a fibroid or small growth is removed.

After your hysteroscopy

After the procedure, your recovery will vary based on the type of anaesthesia you have. Your doctor will keep an eye on you until you are completely conscious if they choose to administer sedatives or general anaesthesia. After the procedure, you may experience:

• Mild cramping and discomfort

• Slight dizziness after the sedation wears off

• You may also experience cramping and vaginal bleeding for one or two days after the procedure

It's normal to experience pain similar to period pain for a couple of days after a hysteroscopy. Taking paracetamol or your usual period pain medication, as advised by your doctor, can help.

However, if you experience a fever, severe abdominal pain or heavy vaginal bleeding or discharge, you should schedule an appointment with O&G specialists.

Hysteroscopy at Thomson Medical

Undergoing a hysteroscopy for the first time can be worrying, especially if you're concerned about whether it will hurt. However, at Thomson Women's Clinic, our obstetrics and gynaecology (O&G) specialists understand your concerns and provide compassionate, non-judgemental support throughout your journey.

They can help answer your questions and ensure that you feel completely supported before, during, and after the procedure.

What to expect during your care:

• Consultation to understand your specific concerns

• Discussion of pain management (anaesthesia) options tailored to your needs

• Clear explanation of findings and next steps

• Detailed aftercare instructions and prescribed medications

• Information on post-procedure care, including potential side effects such as light bleeding or cramping

Hysteroscopy cost in Singapore

The cost of a hysteroscopy varies depending on whether you choose a public or private hospital. Generally, the cost ranges from SGD 696 to SGD 8,326. However, additional charges may arise for expenses such as pre-surgery consultations, imaging tests (e.g., X-rays or CT scans), medications, and post-surgery follow-up appointments.

Fortunately, there are several programmes in Singapore that can help lower the total cost, such as MediSave, MediShield Life, and Integrated Shield Plans. Each of these offers different levels of coverage for your hysteroscopy, depending on your eligibility and insurance arrangements.

This price was last updated in June 2025. Therefore, hysteroscopy costs may have changed since then. For more information, visit our hysteroscopy cost guide or contact our medical concierge.

FAQ

Is hysteroscopy painful?

How long does a hysteroscopy take?

The duration of hysteroscopy can vary. Diagnostic hysteroscopies are usually shorter, typically lasting 15 to 30 minutes. Operative hysteroscopies, which involve additional procedures like polyp removal or adhesion treatment, may take longer, up to an hour or more.

Are you put to sleep for a hysteroscopy?

What conditions can hysteroscopy diagnose and treat?

Are there risks associated with hysteroscopy?

Can hysteroscopy affect fertility?

Diagnostic hysteroscopy is unlikely to impact fertility. In fact, treating certain conditions discovered during hysteroscopy, such as removing polyps or adhesions, may improve fertility. However, it is essential to discuss individual circumstances and fertility concerns with the healthcare provider.

Can hysteroscopy be used to treat heavy menses?

Hysteroscopic resection of fibroids and polyps can reduce menstrual bleeding. In addition, hysteroscopic resection of the endometrium or balloon endometrial ablation can significantly control heavy menses without any skin incision, such that a hysterectomy (removal of the womb) can be avoided.

How often is hysteroscopy recommended?

The frequency of hysteroscopy depends on the individual's health condition. It may be a one-time diagnostic procedure or repeated if ongoing monitoring or treatment is necessary, such as in endometrial hyperplasia. The healthcare provider will determine the appropriate schedule based on the specific case.

The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations and tailored advice, schedule an appointment at Thomson Women’s Clinic.