First, what is an HSG?
Hysterosalpingography (HSG) is an X-ray procedure that is used to view the inside of the uterus and fallopian tubes. It often is used to see if the fallopian tubes are partly or fully blocked. It also can show if the inside of the uterus is of a normal size and shape.
During HSG, a contrast medium is placed in the uterus and fallopian tubes. This is a fluid that contains a dye. The dye shows up in contrast to the body structures on an X-ray screen. The dye outlines the inner size and shape of the uterus and fallopian tubes. It also is possible to see how the dye moves through the body structures.
American College of Obstetricians and Gynecologists
Regular people terms: A medical professional shoots dye into your uterus then uses ultrasound to see how your uterus looks and how the dye flows out your fallopian tubes. Assuming, best case scenario, the dye does actually spill cleanly out of your tubes [and just free flows willy nilly into your body cavity because that’s not alarming or anything]. Not-so-best-case scenario, you’ve got a blocked tube or two and the dye won’t flow through.
I had my HSG back in April 2019.
Preparing for the HSG procedure:
I was advised to take ibuprofen one hour before my appointment time so I took two 200-mg tablets. I didn’t do much other prep. Matter fact, if you’re reading this, you probably prepared more than I did.
The actual HSG procedure:
I had to go back alone, husband couldn’t go with me. Very standard annual exam pap smear type table and sheet set up. The doctor(?) and another woman (I’d requested all women) came in to do the procedure. “Scoot your booty down to the edge of the table, feet in the stirrups”. You know the drill. Still standard.
In goes the speculum. Some explanation about the fluid/dye and that I may feel some “mild discomfort”. Uh huh, I hear you.
Aaaaaand here we go. What is this strange sensation? Slight pressure. But not like someone pressing on me. More like someone filling a miniature water balloon….inside my body. Does this hurt? No. No, this isn’t pain. This is…mild discomfort.
Turns out that balloon sensation is, indeed, a balloon. They insert a balloon-like sac before the dye fluid. The balloon blows up so the uterus can be better viewed and then the dye goes in.
All the while the doctor explained what she was seeing, showing me my uterus and tubes on the screen. By the way, fallopian tubes are TINY. Like, strand-of-hair tiny. It’s a wonder anything can get through them.
And then the dye dumped out of my tubes into my body. Now THAT was uncomfortable. Still not painful though. It was more like a sensation of too much fluid trying to get through too small of an opening. Like something was going to tear or blow if just 5 more seconds of fluid was pumped in. Once the dye dump finished, the pressure subsided. I also recall some lightweight cramping.
The whole thing from speculum-in to booty-back-feet-down took six minutes.
HSG Pain Level:
In my experience: On a scale of 1-10, the HSG was a 2. Maybe even a 1. Keep in mind though, so far my 10 is rupturing my Achilles’ tendon in January. And even that was only a 10 because it’s the most pain I’ve experienced to date. But really, even that wasn’t THAT bad. I’ll probably end up downgrading the Achilles’ thing to a 7, if childbirth is as much a nightmare as women say it is.
Basically, I have a bit of a higher threshold of pain. I don’t think the HSG actually HURT, so much as it got very uncomfortable for about two seconds. If your threshold for pain is lower, you’re going to think the HSG hurts. Plus, my tubes were completely unblocked. If you have blockage, there will be more pain as that dye tries to push through but can’t.
You should be able to watch your whole procedure on the monitor and know your results immediately as it’s all happening.
Aftermath of an HSG:
Nothing major. I had some cramps the rest of the day but I didn’t take any more meds or do anything differently. My result: completely healthy uterus and fallopian tubes. Which is nice and all but frustrating because unexplained infertility.
Anyway, as promised, here’s video of an HSG and how the doctor explained what was happening…
