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Does an HSG Hurt?

What You May Feel, How to Cope


Updated January 26, 2014

Woman with legs in stir ups

During an HSG, inserting the tube with dye feels like having a pap smear, a feeling you're likely familiar with.

Photo (c) Keith Brofsky / Getty

Many women wonder if the hysterosalpingogram (HSG) test will cause pain. An HSG is a special kind of x-ray that involves giving an iodine dye via the cervix in to the uterus and fallopian tubes and then taking x-ray pictures.

Does an HSG hurt? You may or may not experience cramping during an HSG.

Some women report mild-to-moderate cramping. Some don't feel much of anything, and very few report severe cramping. (Personally, I didn't experience more than mild cramps, and it wasn't nearly as bad as I imagined it would be.)

The insertion of the device used to inject the dye in to the cervix may remind you of how a pap smear feels. If you tend to feel pain during regular pelvic exams, you may be more likely to experience cramps.

When the dye is injected, you may feel a strange warming sensation.

If one of the fallopian tubes is blocked, you may feel pain from the pressure of the dye against the blockage.

Ibuprofen, taken an hour before the test, can help. When cramping does occur, it usually lasts a short five minutes, but some women have mild-to-moderate cramping for several hours after the procedure. Over-the-counter pain medication can help with cramping after the test.

Anxiety and fear about the test can increase your perception of pain. The test can be very awkward, with this big x-ray machine hovering over you while you're lying on your back, legs apart, with the speculum inside. They may ask you to roll over to your side for an x-ray or two, and you have to do it with the speculum still between your legs.

It's normal to feel nervous, and relaxed breathing through the procedure can help. A nurse offered to hold my hand, and I took her up on the offer.

When Pain Is Not Normal

While mild cramps are normal, if the pain seems to be increasing after the test or you develop a fever, be sure to contact your doctor.

There is a rare risk of infection following an HSG, and increasing pain may hint to a brewing infection.

More about the HSG test:

More on fertility testing:

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Hysterosalpingogram (HSG): Patient Fact Sheet. American Society of Reproductive Medicine. Accessed November 13, 2008. http://asrm.org/uploadedFiles/ASRM_Content/Resources/Patient_Resources/Fact_Sheets_and_Info_Booklets/hsg.pdf

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