You might remember that I went for a hysteroscopy examination about six weeks ago. I wrote about it briefly in this blog post and promised to elaborate once I had the results and next steps. I was overwhelmed by the number of comments and emails in response to that post. It’s heartening that so many women were willing to share their own experiences about hysteroscopy and about heavy bleeding which is why I had mine. More of that in a moment.
What Is A Hysteroscopy?
So what is a hysteroscopy? Well there are countless excellent websites that explain what the procedure entails. The “mechanics,” I suppose. It is a procedure that uses a hysteroscope, (a very narrow telescope with a light), to examine the inside of the uterus. It is inserted vaginally, through the cervix and into the womb. The consultant will take biopsies of the endometrium, (lining of the womb), at the same time, if necessary. The hysteroscope sends images to a monitor so the consultant can see. It is usually carried out without anaesthetic although it is sometimes carried out under general anaesthetic.
Why I Had A Hysteroscopy
I needed a hysteroscopy because I’ve had heavy menstrual bleeding, menorrhagia, for several years. The definition of menorrhagia is abnormally heavy or prolonged menstrual bleeding. In my case, this amounts to a bleed which lasts for about ten days within a 24-26 day cycle. I get mild stomach cramps and feel light-headed for five days leading up to the bleed, although these pre-menstrual symptoms require little more than a hot water bottle and a few paracetamol. I don’t get the typical mood swings associated with PMT, however, I do feel excessively emotional and tearful. A quick calculation tells you that for 15 out of every 25 days, I am either pre-menstrual or bleeding. It’s no fun.
The bleeding itself is very heavy. I experience flooding and at times I need to change my bedding three times within a night. I get lower backache, headache and severe stomach cramps. The fear of bleeding all over the place stops me going to the gym and I dread standing up after driving for the same reason. I drive my son to play football several times per week and the journey can take up to two hours depending on location. Some matches are played on pitches that have no toilets nearby. I find myself looking for the nearest supermarket so I can use the ladies loos and get changed if necessary.
This heavy bleeding has had a significant impact on me over the last few years. Physically, I feel, (and look), exhausted for the duration of the bleed. I often feel very light-headed and on a few occasions, I have fainted because of low blood pressure. It interrupts my sleep and it’s painful. I often need to change my underwear and sometimes other clothing several times per day. And none of us need any more washing do we?
Emotionally, I feel unattractive and undesirable. The bleeding stops me from doing things I want to do. It makes me think twice about what I wear- I avoid anything fitted or light-coloured and instead choose looser. brighter clothing, often with a pattern; it’s more forgiving of leaks.
At times, I feel like my life revolves around it and I avoid arranging meetings, nights out and other social events during those times.
However, I’m fortunate to have so many good friends who understand and who help with the football runs if necessary. My partner Ian is patient and kind and my parents are wonderful. I’ve told my teenage children on a need to know basis and they know that if I’m a little quieter than usual, then it’s nothing to worry about.
Options To Help Heavy Bleeding
There is a set of protocols set out by NICE for the treatment/management of menorrhagia which must be carried out in order.
The first option is a hormonal one, i.e. the contraceptive pill or the Mirena coil. The combination pill was contraindicated because of the increased risk of thrombosis associated with me being over forty. Consequently, the first thing I tried was a progesterone-only, (mini) pill. It definitely reduced the incidence and severity of the flooding but I had spotting on every other day of the month. I persevered and gave it two years, hoping that one day it would stop. It didn’t.
The next step was the Mirena coil. I know so many women for whom this has been life-changing. Again, it reduced the severity but I was still bleeding heavily and spotting on more days than not. I can’t be certain, but it seemed to exacerbate my lower back pain and made me feel flat. Not low, or depressed. Just flat. Not my usual upbeat, bubbly self. This time I persevered for 14 months. In the end I made an appointment to see my GP because I was thoroughly fed up. She gave me an internal examination then referred me for an internal ultrasound on my pelvis and uterus. This revealed a few small fibroids and that the Mirena coil was sitting a little low. Shortly afterwards, I chose to have the coil taken out by my GP. It was totally painless and took a matter of seconds.
The next thing I tried was Tranexamic Acid. In simple terms, this encourages clotting so in theory reduces blood flow. (It’s used for severe nosebleeds and following certain surgeries for the same reason). This is a course of tablets which must be taken as soon as the period starts and for up to four days each cycle. It seemed to help reduce flooding for two or three days but after that, I found that I was passing large clots which was painful and really just not very nice. I took advice and tried it for three cycles but the clots were worse than everything else. I was very glad to stop taking it.
My Experience of Hysteroscopy
Because I’d tried every option, the next step was referral to a gynaecologist. At the initial appointment, she took a thorough history and told me that a hysteroscopy will rule out anything sinister and will assess suitability for treatment. It is worth mentioning here that I have always kept up to date with smear tests and they have always been normal. There is no history of uterine, ovarian, bladder, bowel or breast cancer in my family. Because of this, I was never worried about anything serious or life-threatening. The fact that nothing got any worse also reassured me that I must be ok in myself.
I had the hysteroscopy about six weeks ago as an outpatient. The nurse checked my blood pressure and took me to theatre. It was carried out without anaesthetic, so once I’d removed the clothes from my bottom half and put a gown on, I got onto the bed. (Operating table sounds a bit dramatic, but I guess that’s what it was). I had to put my bottom towards the foot of the bed and lie down. My legs were elevated and opened and covered with drapes. The initial part of the hysteroscopy was like having a smear test. Slightly uncomfortable and rather undignified, but nothing more than that.
She took endometrial biopsies and then it become more uncomfortable. I could feel the hysteroscope as it moved and that made me jump a few times. I tried not to tense up and did my best breathe through it. I’m really very tolerant of pain and discomfort; I’m not soft. I gave birth to my two children naturally and with only gas and air. Consequently, I expected this to be a walk in the park! My mum advised me to take some painkillers before I went. I had every intention of doing so but I forgot. It would have taken the edge off the discomfort, so I highly recommend it to others.
I was tearful and actually started to cry during the procedure. It wasn’t because of the discomfort or because I was frightened. I still don’t know why really.
The hysteroscopy took about 25 minutes. There was a lot of bleeding immediately afterwards as I’d expected. I got dressed and waited for a short while before the nurse checked my blood pressure again. It was quite a bit lower than it was pre-op and I felt a bit faint, but not enough to worry me. My friend Sue took me and brought me home. Initially, I thought I’d be perfectly fine to drive myself. There is no way I could have managed that. Not only was I light-headed, I was still weepy, (poor Sue wondered what on earth had happened). I felt shaky and was very pale.
The Week After My Hysteroscopy
Sue left me with a much needed cup of tea, a hot water bottle and firm instructions to take it easy. I’d planned to work that afternoon. After all, I do little more strenuous than sit at a laptop. But, no. I had tummy and backache as well as a headache. My friend Sally came later with flowers and gossip and I felt a little better. By bedtime that night I felt a lot less like crying and I expected to be as good as new by morning.
However, I felt exhausted, achey and just not right. It took a week until I felt normal again. I’m always very emotional but this seemed to be heightened to the nth degree that week too. In my previous blog post about this, another lady commented that her friend was emotional too. And a friend of a friend experienced the same. I know this is only anecdotal evidence, but it’s reassuring to know that it wasn’t just me who cried a river after having a hysteroscopy!
I bled for three weeks afterwards. It wasn’t heavy and there wasn’t any flooding but it was enough to make me slightly concerned. I called the gynae ward and they told me that it isn’t unusual.
The Results and Next Steps
I had my follow-up appointment last week. As expected, the biopsies confirmed that everything is normal. However, and I’m delighted about this, I am on the list for uterine ablation. This is the surgical removal of the endometrial tissue which has an 80% success rate in reducing menorrhagia significantly and entirely in some cases. It’s carried out under general anaesthetic and the literature suggests a recovery time of up to two weeks. I can’t tell you how glad I am. It’s not going to be easy sitting still and because I’m self-employed, it will have a financial impact. But, my goodness, if it reduces the bleeding and its associated symptoms, then I shall be one very happy woman. I’m hoping that it will take place sometime in May.
I can’t praise the NHS enough. My consultant and her team are brilliant as are the GPs I’ve seen throughout. I feel fortunate to live in a country that has such a brilliant system. I also feel very fortunate to know that in a few months from now, I’ll feel like my old self. I’ve got so much to look forward to and I can’t wait for summer.
Ian bought the beautiful roses for me. The gorgeous lingerie and dressing gown that I’m wearing in these photographs were a gift from F&F Clothing. They sent a selection to me and it’s all absolutely beautiful. The colour palette is perfect for spring and includes blush pink and sea green. It’s the first time I’ve had any underwear or nightwear from there and it’s lovely; excellent quality and great value. At £18, the floral dressing gown would make a perfect Easter gift.
[shopr_shopthepost collection=”hysteroscopy-post” title=”I’m wearing…”]
Sorry to hear you’ve been having a tough time Lizzy. I hope the ablation works and you’re soon feeling much better.
Aw, thank you so much Emma. I’m really looking forward to getting it done and I’m so optimistic for a successful outcome. Lots of love xxx
I was a gynaecologist secretary for 21 years. This procedure usually is very successful. They always did hysteroscopy under a General Anaesthetic. Cuts to budget instigated local treatment, not good for the patient! Hope all goes well Liz and you get sorted. X
Oh that’s interesting Linda. Wow, no wonder it was more uncomfortable than I anticipated. Not even local anaesthetic or a sedative.I’m so looking forward to the ablation though and I really think it’ll change my life. Fingers crossed for success. So lovely to hear from you by the way. I hope you and the family are well. Love to you all xxxxx
Wishing you well Lizzy. I am interested that you found the hysteroscopy procedure uncomfortable. What would you consider the pain score to have been? I am in a support group where women have unfortunately found the procedure very painfully severe being 7 or above. The procedure being tolerated only because an alternative under GA or local had not been explained.They have also nearly all experienced tearfulness, exhausted and emotional.
Linda Cunliffe I agree it is not good for some patients 10-40% who have a painful experience without giving fully informed consent as pain had not be mentioned as a risk.
It’s great to be able to read such an open and honest account of how menorrhagia can really affect life. So many of my patients delay coming to me with this problem because they’re embarrassed, like it’s taboo. Articles like this will help to erase this stigma and help women to feel confident to get the help they need xx
Oh thank you Katey. As you know, I delayed seeking treatment because I knew that any intervention would mean I’d be away from Poppy and Harry. I need to be on top form for them and their needs but enough was enough. The way it affects me is increasingly more detrimental to them. I can talk to them quite openly and they know what’s what. I’m quite looking forward to them doing the chores for a week, hee hee!!! xxxx
Hi honey, they injected me with local anesthetic for mine. Ooo taking biopsys without it is barbaric and seriously wrong. No wonder you were tearful. The ablation will be fine i had mine on the wednesday on saturday i was cycling round Tiree 😀😀😀😀. Excellent post. Great to share xxx
Oh really? I thought you had yours without any anaesthetic too. Gosh, I wish I’d have known. You fill me with so much confidence about the ablation though. I know how pleased you are with the outcome. Lots of love and see you soooon 😘😘😘xxxx
Such an honest and open account of something that a lot of women can’t talk about ( including me) I was lucky that the Mirena Coil worked for me in my case. I have endometriosis and had terrible flooding and I was desperate for it to work which it did. In fact it changed my life. I know only too well how devastating such a condition can be… I too remember the football trips with my children and scurrying round trying to find a toilet in the middle of no where. I hope and pray that the incoming procedure helps you so you can get on with life without this awful issue hanging over you. Lots of love Susanna xxx
Oh Susanna thank you so much. And you poor thing. Endometriosis is so awful. Much worse than this. I’m so glad to know the Mirena worked for you. I think it’s the progesterone that disagrees with me and causes the spotting. I’m really hopeful of a successful outcome. Thank you for sharing and lots of love xxxxx
Hi I had the same problems as you for years and eventually had the ablation done about 6 months ago. It was the best thing I have ever done – I was fine the next day after the procedure and haven’t had a period since. It’s been life changing! Hope it works for you too! Alison xx
Ps love your posts and blogs 😄
Hi Alison, oh that’s so encouraging to hear. I really can see how a successful outcome will change my life. I’m so pleased you’ve had such a positive result. And thank you for the lovely compliments about my posts and blog. It means so much. Lots of love xxxxxx
Very well written piece.
I had several hysteroscopies over a number of years, my first at 43yrs, because of heavy and very irregular bleeding. My outcome was simply the beginning of menopause, but this spanned over 5 years and the worry and pain as you say was considerable.
Again, like yourself I was treated amazingly well by all NHS staff, and would only advise, if you feel something’s not quite right, go and get it checked out.
Hi Claire, thank you very much for the compliment and for getting in touch. Gosh, five years is a long time isn’t it to be in this sort of pain and discomfort. It’s interesting because a friend of mine was told, following a hysterectomy that it was the start of the menopause too. it is something I’ve wondered about but they haven’t checked my hormone levels. And you are absolutely right. it’s vitally important to go and get checked. I waited for much too long because I am on my own with my children (I do of course now have my wonderful partner Ian, but we don’t live together and have been together just 18 months), and I knew that any treatment would impact on us. However, I always felt that there was nothing sinister or life-threatening and I just hoped and hoped things would settle. I hope things are better now for you. Thank you again and very best wishes xxxxx
Your experience almost mirrors mine – Unfortunately my uterine ablation didn’t work in the long term ( immediately I felt so much better and no bleeding then 2 months later it started again 😢) However after speaking to my consultant I decided to go down the hysterectomy route and can honestly say I have never felt better- no panics about what to wear or problems when out or on holiday ( what a nightmare that was ) no pmt or mood swings.
I really hope yours works and you don’t need any further ops but wanted to say if it doesn’t there are other options and as my gynaecologist said a hysterectomy is like turning off the tap for good.
You will feel like a new woman when it’s finally sorted.
Hi Sarah, oh you poor thing having to go through the ablation and the hysterectomy. I must say that it is a fear of mine that the ablation won’t “cure” me, but I know the statistics are in my favour. If it came to it though, I would of course have a hysterectomy to end it once and for all. And it’s wonderful to hear that your hysterectomy has changed your life for the better. It is such a nightmare isn’t it worrying what to wear, especially as you say on holiday, along with all of the seemingly small but very real issues that all add up. I am so looking forward to feeling like a new woman, whether that is just from the ablation or whether I will need more radical treatment. bring it on! Thank you again and lots of love xxx
I had a hysteroscopy a few years ago because I had regular mid-cycle bleeding. I was told it was normally done without anaesthetic but as I’m so squeamish I insisted on a general anaesthetic – I didn’t realise this used to be the norm, how awful to hear that it no longer is. I hope the ablation is successful for you, my mum suffered from severe flooding and I remember how negatively it impacted on her life.
Thank you so much Pamela. Your poor mum. It really does impact negatively. I hope you got answers or a solution to your mid-cycle bleeding. That must have been such a worry for you. I do feel very fortunate that I knew there was nothing sinister or life-threatening about my bleeding but mid-cycle bleeding is such a cause for concern. I am grateful not to have had the mental anguish of awaiting test results because I was so certain everything was “normal”. When I had the hysteroscopy, I just assumed that it had always been done that way- without any anaesthetic, sedative or pain relief. It’s come as a surprise that it usually IS done with local anaesthetic and that yes, previously, was usually done under general. Thank you so much for commenting and lots of love xxx
This is amazing to read and incredibly helpful. Thank you Lizzi xxxxx
Oh Helen, thank you so much. I really hope it will help others, or at least reassure that it is such a common problem and that there are potential solutions. Have a lovely day and thank you again xxxx
Hi, a really great blog post. Thank you for sharing. I hope everything works out for you. I enjoy your insta feed but it has been good to hear more about you as a person. Xxx
Hi Deb, thank you so much. That’s really lovely of you to say. I’m very, very hopeful of a successful outcome. By summer, I think I’ll feel like a new woman and like my old self and I can’t wait! Thank you very much for your kind words xxxxx
So sorry that you’re having such a difficult time Liz. As others have mentioned, I can totally understand why your felt emotional and tearful, having the procedure without being given a local and/or a sedative … seems unnecessarily painful and stressful to me … Such a well written and honest post that I’m sure will be helpful and reassuring to lots of women. Take care Rosemary xx
Thank you Rosemary. Yes, it has been a tough few years in many ways, but I’m so lucky to have so many people looking out for me. And, there is light at the end of the tunnel which for many people, isn’t the case. I’m really looking forward to the ablation and really do feel optimistic of a “cure”. Lots of love xxx
Oh Lizzy, it sounds like you’ve been through hell. To have that for so many days and so often must seriously take it out of you. I really feel for you. And I will not complain about my own much lighter periods ever again! I do hope the procedure happens really soon and is a success for you, because you deserve it!
And you look absolutely beautiful in these photos. The nightwear from F&F is beautiful Love the colours!
Yes, it’s been tough at times Suzy but there is light at the end of the tunnel and I am very positive about having a successful outcome. I’m looking forward to getting a date for the ablation. And thank you. The lingerie is so pretty isn’t it. Have a lovely weekend xxx
Oh darling, I’ve never heard of this being done without an anaesthetic. You are so brave. Thank you for sharing this. Hope you continue feeling feel and the next procedure goes well. You are such a beautiful, positive lady and I really want to meet you soon. Lots of love xxx
Aww, thank you Vicky. I am sure the next procedure will go really well and it’s something I’m looking forward to. I’d love to meet you too xxx
Hi Lizzy. I had ablation a few years ago. It has had a brilliant effect on my periods. Hardly any bleeding and only lasts 3 days. Sometimes it’s so light you don’t even notice them. The procedure was fine. General anaesthetic – so no pain. Groggy afterwards and painful cramps but after a week of rest I was back at work with no problems. I keep encouraging my sister to ask her GP as she suffers with heavy periods. Hope it works for you and I’m sure you’ll be fine after a few days. I certainly didn’t need 2 weeks to recover. Good luck! 😉
Oh Louise,thank you so much for this. It is very reassuring to know that so many women have had a successful outcome. A week of discomfort afterwards will be worth every moment! And like many women, you didn’t need two weeks of recovery so that is very encouraging too!I do hope you manage to persuade your sister to get the help that is available and I’m so pleased you’ve had such a brilliant outcome. Thank you again and lots of love xxx
This post is so enlightening, heartfelt yet educational…You did an incredible job here Liz. The writing is superb my friend & thank you for being so honest. Many Women will relate to this so knowing how vulnerable you felt will give them comfort. Being tearful during this procedure is completely understandable & I believe hormone related. We never give those old hormones enough credit do we? Their power to make or break us is enormous. I’m so happy this terrible condition is almost over for you & YAY to the NHS!
Thank you so much MT. I was inspired somewhat by your brilliant menopost series. I have learned so much from you. Yes, hormones have a lot to answer to don;t they, both good and bad! And yes, the end is in sight and I can’t wait! xxxx
Thank you for this information. I have had crazy heavy periods for a long time too and am currently booked for Hysteroscopy in 2 weeks time. Beautiful piece and quite reassuring. x
Thank you Vicki. I really hope you get the same positive outcome as I have done. I went on to have a uterine ablation which has been life-changing. No bleeding at all since xxx
I’m waiting for a hysteroscopy and have basically worked myself into a state over it after reading stories on other sites. Yours is a bit of a balm. 🙂
As to feeling emotional after such a procedure, I thought I’d share what I learned after nearly passing out when my GP tried to do an endometrial biopsy with her usual speculum and on-hand tools. First, that those “standard” tools will likely not get the job done if your biology deviates from textbook “normal.” She told me that my biology was “odd” (I’m assuming she meant anatomy and I’m further assuming she meant that my uterus was retroverted – because that’s not news to me at this point), and that only a gyn with specialized tools could finish the job. Second, when they say, “you’ll feel a pinch,” they are LYING. Third, when you nearly faint, the apparent appropriate response is, “Oh, yeah, that happens to a lot of women when we do this.”
This last prompted me to do some research. it didn’t take much to learn that the vagus nerve is RIGHT there where your doctor is prodding around your cervix, and since the vagus nerve is connected to most everything in the body including other major nerve pathways, you’re GOING TO FEEL like you’ve never felt before, be it emotionally or physically. Feeling very emotional or sort of drugged/zombie-like is totally part of that. I had to sit for 20 minutes in the waiting room before I could pick up my phone to call for a ride. I still have no idea what the doctor said to me after the attempt but I know there were a lot of numbers and dosage amounts involved; had to call back the next day to ask. OTOH, the gyn and his special tools were in and out in 30 seconds, offered me a student’s hand to nearly break in two from squeezing through the “pinch” (he then told her that next time she should offer her non-dominant hand!), and still couldn’t get a good sampling, so now it’s hysteroscopy time. There was no faintness with the gyn’s attempt, he explained each move he was going to make, and it still left me feeling like I’d been run over.
There are good images available online of these connections; just Google “cervix connections to nerve pathways” or “cervix vagus nerve”.