If your doctor orders an HSG (which is much easier to say than hysterosalpingogram) you may have heard stories from friends who have had them - or perhaps you've read some (scary) accounts on the internet. These may make you hesitate before scheduling that procedure! But we're here to tell you, while not a cakewalk, the procedure is really not so bad - and lest you think we speak without knowledge, know that both your blogger docs have had the procedure and survived.
The HSG is one of those tests where it truly is hard to predict the level of discomfort. Experiences are individual - just as some have passing menstrual cramps and others have pain that keeps them in bed, some will say of an HSG, “Meh.” Some will say, “Ugh.” Others may truly experience pain. Your experience may fall anywhere on that spectrum, but there are things you can do to make the experience more comfortable. Communication is, as so often is the case with comfort, key.
In the past we’ve covered the specifics of what goes on in the procedure (here), but to briefly reiterate: an HSG involves injection of a contrast material into the uterus and uses x-ray technology to obtain images of the uterus and the Fallopian or uterine tubes, looking for any potential blockage.
Almost ALL of our patients express post-procedure relief that it wasn’t as bad as they feared. The most common comment - that wasn't nearly as bad as I thought it would be - wish I hadn't read all those stories on the internet! This made us think, how can we help to reduce your fear?
An HSG involves a lot of setup. The initial part of the study is about visualizing the cervix and getting the instruments in place so that the contrast material can be injected in your uterus. This is similar in discomfort to your routine pelvic exam- no picnic, but tolerable. The next part of the procedure is filing the uterus with the contrast material and getting our images. This is the part that will produce cramping from contrast filling the uterus, similar to menstrual cramps at their most intense. This part is fairly brief, usually 10 minutes or less. The discomfort ends when the procedure does -so breathe, relax and remember it will all be over in short order.
Now, here are some things you can do to help yourself. First off, ibuprofen is a minor miracle in preventing the cramping. You will be instructed to take some ibuprofen pre-procedure which will make the whole event more tolerable. Next, if you tense up, it is harder to insert the speculum and harder to get the instruments in the right position - so breathe. A few slow, deep breaths can go a long way in relaxing you and your muscles!
It’s helpful to know what your prior experiences are to gauge your potential HSG experience. For women with extremely painful periods, HSGs tend to be more uncomfortable. For women who have had children, HSGs are generally easier to tolerate. If it turns out that your fallopian tubes are blocked, the discomfort will be slightly more intense but will subside fairly quickly once the procedure is complete. And remember, blocked tubes are seen in only a small percentage of women.
If you have difficulty undergoing regular female pelvic exams, please do communicate this. Your radiologist will work with you to help make you more comfortable. Sometimes, it’s as simple as using a different speculum - they come in all shapes, just as we do.
All told, an HSG is an incredibly valuable form of imaging when pregnancy is your goal. We hope this brief discussion will help relieve some of the pre-procedure fright, and we have a feeling you too will be likely to say, “That wasn’t so bad.”
Originally published 3/11/14 on diagnosticimagingcenterskc.com.