Alternatives tohysteroscopy

For some people, the cause of uterine problems may be diagnosed with a less invasive procedure. Problems like heavy bleeding, irregular bleeding and period pain may be controlled with medication in some cases.

Less invasive procedures

Transabdominal ultrasound

This is a type of ultrasound for examining your uterus. It can be helpful in diagnosing the cause of pelvic pain, abnormal bleeding, menstrual problems, fibroids, endometriosis and infertility.

Transvaginal ultrasound

An ultrasound technician inserts a probe into your vagina to produce an image of the inside of your uterus. While it’s more invasive than a transabdominal ultrasound, it’s not painful and a transvaginal ultrasound can produce clearer images of your uterus than a transabdominal ultrasound.

For both types of ultrasound, the imaging laboratory or your doctor will probably ask you to drink plenty of fluids in the lead up to your ultrasound and not empty your bladder. A partially full bladder makes it easier to see the uterus with ultrasound.

Endometrial biopsy

This is an alternative way of taking a sample of the lining of your uterus. After inserting a speculum into your vagina to see your cervix, your gynaecologist passes a narrow tube through it and into your uterus. Your doctor applies suction to the tube to remove a sample of the lining. It can be done in your doctor’s rooms. The sample taken will be sent for a biopsy.

These alternatives can be used ahead of a hysteroscopy and depending on the findings, you may not need to have a hysteroscopy. On the downside, they don’t provide as much information as hysteroscopy and they can't be used to treat problems in the same way as a hysteroscopy.

Medication

There are a number of medications that can be used for heavy and/or irregular periods and period pain:

• Anti-inflammatories like ibuprofen or naproxen can reduce bleeding and also relieve period pain and cramps.
• Transexamic acid (Cyklokapron^®) is a medication that can reduce menstrual bleeding.
• Certain oral contraceptives can help to regulate your cycle and reduce bleeding.
• Progestogen tablets can help with bleeding if it’s caused by a hormone imbalance.
• Intra-uterine contraceptive devices (IUDs) like Mirena^® and Kyleena^® can reduce bleeding by thinning the lining of your uterus.
  
• Injectable contraceptives like Implanon^® and Depot Provera^® are also helpful.

Dilation and curettage (D&C)

Dilation and curettage can be used as an alternative to hysteroscopy, but it tends to be more invasive with a longer recovery time. Under general anaesthesia your doctor dilates your cervix and removes the contents and/or lining of your uterus. It’s used for a range of conditions including heavy bleeding, removing polyps, treating incomplete miscarriage and unwanted pregnancy. It can also be used for diagnosing uterine cancer and infertility.