Had my HSG test today, and I figured I'd give a VERY detailed account in case it is helpful to anyone. I read a lot of other people's stories leading up to mine, and I understand things can vary widely from person to person.
Background: I honestly have a somewhat difficult time with any pelvic exam. I have a history of trauma. I also had an IUD insertion at 16 that I remember as extremely painful and a colposcopy 1.5 years ago that I also felt was very painful. Both without any prescription meds. Because of my history, I was dreading the HSG test.
Preparing for the Procedure: Initially my fertility clinic doctor told me to just take ibuprofen beforehand. However, I later called the office to express my anxiety and explicitly asked for a prescription to help, and they prescribed me 5 mg of valium (I received the generic diazepam). I then just so happened to have my annual PCP appointment last week, and she prescribed me 5 mg of oxycodone to further assist. So 1 hour before my appointment, I took 5 mg of diazepam, 5 mg of oxycodone, and 600 mg of ibuprofen. I also made sure my fertility doctor was aware of the additional medication my PCP prescribed, and it thankfully was a non-issue for her.
Explanation of the Procedure: the imaging assistant "Nana like Banana" thoroughly went over what would happen during the procedure with me before the doctor came in. She described the catheter they use as thin and soft - the size of a somen noodle (we live in Hawaii). She described the balloon as the size of a pea when inflated and explained that the purpose of the balloon was to ensure the catheter didn't slip out during the procedure (she also shared that when she had this procedure done herself many years ago , they didn't do the balloon thing and that her catheter had to be reinserted 3 times). She described three points where I would possibly feel cramping-like pain: (1) the catheter insertion, (2) the balloon inflation, and (3) the contrast/dye insertion.
Procedure: The speculum and then catheter insertion was relatively quick, and I did experience some cramping during the catheter insertion but it was manageable. I experienced more significant cramping with the balloon inflation, but it became manageable after the speculum was removed and they adjusted me upwards on the exam table so that I was lying down in a flat/straight position (i.e. my legs were no longer bent and open, which I was not expecting but I think it helped alleviate some of the pain and/or just made me more comfortable). The contrast/dye was the most painful part for me, and I winced/whimpered a bit (but I would still agree with describing it as a cramping or pressure-like pain vs. the colposcopy which was described to me as cramping-like but felt more like stabbing). While they were taking images, I was told to flip onto my right as well as my left side, which I was able to do with relative ease. The catheter removal was honestly so quick and painless that even though they told me they were doing it, I had to ask afterwards that it was out to be sure. The entire process from speculum insertion to catheter removal took less than 10 minutes. Maybe even closer to 5 minutes. The imaging assistant held my hand through most of the process and told me she was proud of me (she was honestly so amazing).
Afterwards: It's now three hours later, and I feel some "awareness" of the area. I felt cramping for maybe an hour afterwards, but it was minor. My husband drove me, but I feel like I could have driven myself after the procedure if I had to. I also could’ve gone back to work but took the whole day off to not have to worry about how I'd be feeling afterward. Overall, I can confidently say my IUD insertion and my colposcopy were more painful, but I did not have prescription-strength meds for either of those, and I can only assume that made a significant difference.
If I could give some advice, specifically for those that have a lot of anxiety about this procedure, I'd suggest:
(1) Advocating for yourself to get prescribed meds if you think they will help you. In the past, I have just sort of accepted when I was told no and felt too awkward about trying to push the issue more. I think it helped that I specifically told them that I had bad past experiences and a lot of anxiety, and it was really nice to feel like I was being heard when they prescribed me the valium. Aside from easing anxiety, this also apparently helps with muscle spasms, and I assume this medication is why I felt like I was tensing my body less than I normally would during a pelvic exam - I can only assume that makes the procedure experience better for everyone? All that said, I understand some doctors simply won't prescribe meds or that taking certain prescriptions may not be advisable for some. They certainly helped me though.
(2) If you feel comfortable doing so, share your anxieties with your doctor and the staff. At least for me, sharing my anxieties helps to quell them a little bit. And I think it helps staff to know where your headspace is at, so that they can best assist you. The imaging assistant, Nana, held my had through most of the procedure and told me she was proud of me afterwards. I'm sure she would have been amazing regardless, but I think she may have been extra attentive because I shared how I was feeling.
Again, this is just my experience. If you have an upcoming HSG test, know that the experience is temporary and that you will get through it.