A hysterosalpingogram, often called an HSG, is a common fertility test used to check whether the fallopian tubes are open and whether the shape of the uterus looks normal.
It can be an important step in a fertility evaluation, but it is also one of those procedures many people feel nervous about.
And honestly, that is understandable.
Some people describe an HSG as quick and manageable. Others experience cramping, pressure, or anxiety during the test. The experience can vary from person to person.
The good news is that there are simple ways to feel more prepared and more comfortable.
These 10 honest tips can help you understand what to expect, what to ask your provider, and how to reduce discomfort before, during, and after your HSG.
Key Takeaways
An HSG is a short fertility test used to evaluate the uterus and fallopian tubes.
Mild to moderate cramping is common, especially when the dye is injected.
Taking an NSAID before the procedure may help reduce cramping for some people.
Scheduling the test during the correct cycle window is important.
Breathing, communication, comfort items, and aftercare planning can make the experience feel less overwhelming.
Always follow your clinic’s instructions and ask your provider what is safe for you.
Disclaimer
This article is for informational purposes only and is not intended to provide medical advice. Always follow your provider’s instructions and speak with your doctor, fertility clinic, or radiologist before taking medication, using sedation, or making decisions about your procedure.
First, What Is an HSG?
An HSG, or hysterosalpingogram, is an imaging test that uses contrast dye and X-ray imaging to look at the uterus and fallopian tubes.
During the procedure, a provider places a small catheter through the cervix and gently injects contrast dye into the uterus. The dye helps show whether the fallopian tubes are open and whether there are any visible structural concerns.
Your provider may recommend an HSG if you are being evaluated for infertility, recurrent pregnancy loss, tubal blockage, or uterine cavity concerns.
The test is usually quick, but it may cause temporary cramping or pressure.
That is why preparation matters.
1. Ask About Taking Ibuprofen or Naproxen Beforehand
One of the most common tips for HSG discomfort is taking an NSAID, such as ibuprofen or naproxen, before the procedure.
Many clinics recommend taking an anti-inflammatory medication about 30 to 60 minutes before the appointment to help reduce cramping.
Why This May Help
The cramping during an HSG is often caused by the uterus reacting to the catheter, pressure, and contrast dye.
An NSAID may help reduce prostaglandin-related cramping and make the experience more manageable.
What to Ask Your Provider
Should I take ibuprofen or naproxen before my HSG?
What dose do you recommend for me?
How long before the procedure should I take it?
Should I avoid NSAIDs because of any medical condition, medication, allergy, or treatment plan?
Important Note
Do not take NSAIDs if your provider has told you to avoid them or if you have a medical reason they are not safe for you.
2. Ask Whether a Topical Anesthetic Is Available
Some providers may be able to use a topical anesthetic on the cervix to reduce discomfort.
One example is benzocaine gel, which has been studied for pain reduction during HSG.
Why This May Help
Some discomfort during the procedure can come from the speculum, cervical contact, catheter placement, or uterine cramping.
A topical anesthetic may help reduce cervical discomfort for some patients.
What to Ask Your Provider
Do you offer topical anesthetic for HSG procedures?
Would benzocaine gel or another numbing option be appropriate for me?
Is it used routinely or only upon request?
Are there any risks or side effects I should know about?
Fertility-Friendly Tip
This is a good question to ask before the day of the procedure so the clinic has time to tell you what options are available.
Resource: Topical Anesthetic and HSG Pain
3. Practice Relaxation Breathing and Visualization
It may sound simple, but breathing can make a real difference.
When you are anxious, your muscles may tighten, your pain perception may increase, and the procedure can feel harder than it needs to.
Slow breathing helps signal safety to your nervous system.
What to Try During the Procedure
Try this simple breathing pattern:
Inhale slowly through your nose for 4 counts.
Exhale slowly through your mouth for 6 counts.
Relax your jaw, shoulders, belly, and pelvic floor.
Repeat during the dye injection or any cramping.
You can also use visualization.
Picture your body softening, opening, releasing, or staying grounded through the temporary discomfort.
Why This Helps
Relaxation techniques may not erase discomfort completely, but they can help you feel less panicked and more in control.
4. Schedule the HSG During the Right Cycle Window
Timing matters for an HSG.
Most providers schedule the procedure after your period has ended but before ovulation.
This is often around cycle days 5 to 12, though your clinic may give you a specific window.
Why This Matters
Scheduling during the right time may help:
Avoid doing the test during pregnancy
Reduce infection risk
Improve visibility
Make the timing easier to coordinate with your cycle
Reduce unnecessary anxiety
What to Do
Track the first day of your period as cycle day 1.
When your period starts, contact your clinic to schedule the HSG within the recommended window.
What to Ask Your Provider
What cycle days do you recommend for my HSG?
Should I avoid intercourse before the procedure?
Do I need a pregnancy test before the HSG?
Should I call on cycle day 1 to schedule?
Resources:
5. Communicate With the Clinician During the Procedure
You do not have to silently push through pain.
During the HSG, communicate with the clinician if you feel intense discomfort, pressure, dizziness, nausea, or anxiety.
What You Can Say
Try simple phrases like:
“I need a second.”
“That pressure is getting stronger.”
“Can you pause for a moment?”
“Can you tell me what part we are on?”
“I am feeling lightheaded.”
“Please talk me through what is happening.”
Why This Helps
Sometimes a provider can pause, adjust, slow down, explain what is happening, or help you breathe through the hardest part.
Feeling included in the process can make the experience less scary.
6. Bring a Support Person and Wear Comfortable Clothing
An HSG is usually an outpatient procedure, but you may still feel crampy, emotional, or drained afterward.
Bringing a support person can help you feel calmer before and after the appointment.
Why This Helps
A support person can:
Drive you home if needed
Help you feel less alone
Listen to instructions
Offer emotional reassurance
Help with food, water, or aftercare afterward
What to Wear
Choose clothing that is easy and comfortable, such as:
Loose pants
A dress or skirt
Soft underwear
Comfortable shoes
Layers if the clinic is cold
Bring a pad, since spotting or discharge can happen after the test.
Resource: Cleveland Clinic: Hysterosalpingogram
7. Ask About Mild Sedation or Anti-Anxiety Options
If you are extremely anxious, have a history of painful procedures, trauma, vasovagal reactions, or severe pelvic pain, ask your provider about anxiety support before the procedure.
Some clinics may offer or discuss options such as:
An anti-anxiety medication
Light sedation
Extra time for the appointment
A trauma-informed approach
A support person in the room, if allowed
Additional pain management options
Why This Matters
Anxiety can amplify pain.
If you know you tend to panic during pelvic exams or procedures, it is worth discussing options ahead of time instead of waiting until you are already in the room.
What to Ask
Do you offer anti-anxiety medication for HSG?
Is light sedation available?
Would I need someone to drive me home?
Are there extra precautions or instructions?
Can the provider talk me through each step?
8. Remember That the Most Intense Part Is Usually Brief
The HSG can feel intimidating because people often hear scary stories online.
But for many patients, the most uncomfortable part lasts only a short time.
The cramping may peak when the contrast dye is injected, then ease fairly quickly once the test is done.
Mindset Tip
Try repeating a phrase like:
“This is temporary.”
“I can breathe through this.”
“This part is brief.”
“I am safe, and this will pass.”
Why This Helps
Knowing that the most intense part is usually short can make the discomfort feel less overwhelming.
It does not mean the procedure is painless for everyone, but it can help you mentally prepare.
9. Prepare for Normal Aftercare
Mild cramping, light spotting, and watery discharge can be normal after an HSG.
The discharge may include some of the contrast dye leaving the body.
What to Have Ready
Before your appointment, consider having:
Pads or pantyliners
A heating pad
Water or electrolyte drink
A light snack
Comfortable clothes
Your approved pain reliever
A quiet plan for the rest of the day
What May Be Normal
Some people experience:
Mild cramping
Light spotting
Watery discharge
Temporary pelvic pressure
Feeling tired or emotional
When to Call Your Provider
Contact your provider if you experience:
Heavy bleeding
Fever
Severe or worsening pain
Foul-smelling discharge
Dizziness that does not improve
Signs of infection
Pain that feels beyond what your clinic told you to expect
Resource: Cleveland Clinic: HSG Aftercare
10. Read Patient Experiences Carefully
Reading real patient stories can be reassuring, but it can also increase anxiety if you only read the worst experiences.
The truth is that HSG experiences vary widely.
Some people say it felt like strong period cramps. Some say it was very painful but quick. Others say it was easier than expected.
How to Use Patient Stories Wisely
Look for practical tips, not fear-based stories.
Pay attention to:
What helped them feel prepared
Whether they took pain medicine
How long the discomfort lasted
What they wish they had known
What they recommend asking the clinic
Helpful Mindset
Someone else’s experience is not a guarantee of yours.
Use stories for preparation, not prediction.
Quick Checklist Before Your HSG
Use this checklist to feel more prepared:
Ask your provider whether you should take ibuprofen or naproxen before the procedure.
Confirm the correct cycle day window.
Ask whether topical anesthetic is available.
Ask about anxiety support or sedation if needed.
Wear comfortable clothing.
Bring a pad or pantyliner.
Bring a support person if allowed or needed.
Practice slow breathing before the appointment.
Tell the clinician if you need a pause.
Plan a lighter day afterward.
Keep approved pain relief and a heating pad ready at home.
Know your clinic’s red flag symptoms and aftercare instructions.
Questions to Ask Your Provider Before the Procedure
Before your HSG, consider asking:
What should I take for pain relief before the procedure?
Should I avoid NSAIDs for any reason?
What cycle days should I schedule this?
Do I need antibiotics?
Do I need a pregnancy test beforehand?
Can I bring someone with me?
Will I be able to drive myself home?
Do you offer topical numbing medication?
Do you offer anti-anxiety medication or sedation?
What should I expect afterward?
When should I call if something feels wrong?
Final Thoughts
An HSG may be uncomfortable, but it is usually a quick procedure that can provide valuable fertility information.
The goal is not to pretend it is no big deal.
The goal is to prepare honestly.
Pain medication, proper timing, breathing techniques, communication, comfortable clothing, support, and aftercare planning can all help make the experience feel more manageable.
If you are nervous, tell your provider ahead of time.
You deserve clear instructions, realistic expectations, and a plan that helps you feel as comfortable and supported as possible.