Today in this week’s RITUAL FERTILITY LOVE blog post, we’re going to talk about two tests that women often get when they begin their fertility inquiry with a reproductive endocrinologist: Hysterosalpingogram (HSG) and Hysteroscopy.
I often recommend these to my clients who are seeing me but haven’t started a process with a western fertility specialist quite yet. In this email, I’m going to:
Break down the difference between these two tests
Share which one I recommend for most women who may only just be a few months in their fertility journey …and WHY I recommend it
Offer you guidance and support around HOW to take care of yourself when you’re planning on having these procedures done–before and after. I’ve found that most providers aren’t talking about this and it is THE BUSINESS. So make sure you read until the end where the most important part of this email is (in my opinion)!
If you’re like any other woman, it’s probable that you’ve had a least one fairly traumatizing experience with a practitioner performing a procedure or test on you (hello speculums….I’m looking at you…), so I want to make sure you feel ready and supported.
The Two Hystero Tests
So let’s talk about these two tests: Hysterosalpingograms and hysteroscopies are both diagnostic procedures used to evaluate the uterus and fallopian tubes in women. However, there are some differences between the two.
A Hysterosalpingogram (HSG) is an imaging procedure that involves injecting a contrast dye into the uterus and fallopian tubes. X-ray images are then taken to evaluate the shape and condition of the uterine cavity and whether there is blockage of the fallopian tubes. HSGs are commonly used to assess the presence of uterine abnormalities, such as polyps, fibroids, or adhesions (when scar tissue connects two parts of the body together internally that shouldn’t be), as well as fallopian tube blockages.
A Hysteroscopy is considered a minimally invasive surgical procedure that allows your provider to visualize the uterine cavity using a thin tube with a camera inserted through the cervix. Hysteroscopies provide a detailed view of the uterine lining, allowing for the detection of abnormalities such as fibroids, polyps, or adhesions. Hysteroscopies are also used during the removal of polyps or fibroids, and in treatment of uterine adhesions.
Which Test I Recommend Often
Of the two of these procedures, I often recommend women get an HSG if they fall into my When to Get Support category. Follow that link and read my guidelines for when to reach out for more help with your fertility.
Sometimes women have no idea their fallopian tubes are blocked, and can spend too much precious time trying to conceive before finding out all of their endeavors were for naught. We can’t have this! This is one reason I recommend not waiting super long to figure this out if you’re in your late 30s or early 40s.
Another interesting thing about this procedure is that sometimes if you have blocked tubes, it could indicate that there is damp phlegm stagnation in your fallopian tubes (ie. mucus blocking your tubes). This could indicate issues with digestion and intestinal bacterial overgrowth. It could also indicate that endometriosis could be a factor. Of course, all of these things would have to be looked at further, including with further testing.
If the procedure itself is very painful, it can also indicate some kind of abdominal/uterine stagnation, and again that could be endometrial tissue growing in the wrong place (endometriosis). Again, these alone are NOT diagnostic tools but are arrows leading us in a direction so we can investigate more. All of this information is valuable when we are looking to see what’s happening so we can come up with a personal plan to support you with food, supplement, and lifestyle choices.
One other important and helpful thing to note is: The test can also be the cure. If you get an HSG and they determine that your fallopian tubes are indeed blocked, you can actually get a SECOND test and the actual action of the dye shooting through the tube (I know, it sounds intense…) can act as a tube clearer and help to break up the mucus blocking them. I wish more women knew this! So, you can ask your provider about doing this with you if you happen to be someone who falls into this category.
How to Take Care of Yourself
Clinically, I’ve seen that many women are unprepared physically, mentally, and emotionally for many of their procedures…and it’s not their fault! Providers often haven’t personally experienced those procedures, so they really have no way of knowing -how- it actually feels to be the person on the other end of the process. The preparation they offer is fairly standard, and also IMO doesn’t really prepare women effectively. Here are some things you can do to make the experience more comfortable, and hopefully avoiding any kind of traumatic experience that can arise from unexpected pain or lack of support day-of:
DON’T DRIVE HOME: Before you get either of these procedures, I recommend having your partner come and support you. Often the provider’s office will tell you that you’ll be able to drive home. You might be technically -capable- of driving home, but after your procedure you may find that you might actually want to be taken of.
In my practice, I’ve noticed that these procedures can sometimes leave women feeling vulnerable and ungrounded, understandably! Let’s be real: having a metal tool inserted into your body is invasive, no matter how they’re explained to you clinically! Having a supportive person to be there for you and give you emotional care is integral IMO.
TAKE SOME IBUPROFEN: In preparation for a Hysteroscopy, you can take up to 800 mg of ibuprofen to help reduce any pain you may feel. Some practices offer local or general anesthesia, but in case they don’t, it would be helpful to prepare.
ENDOMETRIOSIS TIP: If you have been diagnosed with Endometriosis, you will probably want to get the HSG done. That way, you can be certain there is no tissue blocking your fallopian tubes. It’s possible that if you had surgery, they cleared any away, but it’s possible that tissue can grow back after a few months, so you’ll want to maybe check this periodically.
Tip: Working on nutrition and supplementation has profound affects on the prevention of tissue growing back, so I highly recommend working with someone who can guide you to make sure your surgery has the best outcomes for months down the road. What you eat is everything in preventing inflammation and helping keep your body detoxed.
EAT WARM, COOKED FOODS: After our bodies go through something potentially physically intense, we can nurture and ground them with love and support by eating really yummy, warm, nourishing foods. Eating root vegetables, some nourishing broth, and some chicken is a balm for easing our nervous system and tissues that were physically affected by the procedure.
HOT WATER BOTTLE: Hot water bottles are magic for our abdomen and uterus. The heat helps heal our tissues, calm our nervous system, and if we are having post-procedural cramping, they help ease them and calm our uteruses. I can’t recommend them enough!
GIVE YOURSELF TIME: If you have the privilege of not running back to work after you have these procedures done. It’s possible the procedure may not have any residual effect day-of, but in the case it does, it can be great to just have the rest of the day to rest and take care of yourself.
We forget how invasive these procedures can be…and even if our BRAIN and/or BODY doesn’t respond to the treatment, our nervous system and emotions might have another opinion. Allow yourself to feel the feelings coming up, to process them, and to give yourself time to journal or talk through them with your partner.
Ok, so that’s that! I hope this email helps you think about these procedures and how to support yourself with love and kindness if and when you need them.
Have a beautiful week,
Caroline