HSG Test for Blocked Tubes — What to Expect, Explained Simply

What is an HSG? HSG (Hysterosalpingography) is an outpatient X-ray procedure where a water-soluble dye is injected through the cervix into the uterine cavity and fallopian tubes. The dye shows up on X-ray and reveals the shape of the uterine cavity and whether both tubes are open, blocked, or damaged. When is it recommended? For any woman with infertility, especially when PID, endometriosis, previous ectopic pregnancy, or pelvic infection is suspected. When is it done? Days 7–10 of your menstrual cycle — after menstruation ends but before ovulation. This minimises the risk of accidental radiation exposure to a newly fertilised egg. Does it hurt? Most women describe it as cramps similar to or slightly stronger than period pains — lasting 10–15 minutes during and after the dye injection. Taking an NSAID (ibuprofen) 1 hour before the test significantly reduces discomfort. You can return to normal activities the same day. What do results mean? Normal result: Dye flows freely through both tubes and spills into the pelvis — both tubes are open. Abnormal results: Dye stops midway (blocked tube), fills only part of the cavity (fibroid or polyp), or shows an irregular shape (septum or adhesions). Important note: HSG has a false positive rate for tubal blockage — muscle spasm during the test can mimic a block. Laparoscopy is the gold standard for confirming true blockage. The 'therapeutic effect' of HSG: Studies show conception rates improve in the 3–6 months after HSG, possibly because the dye flushes mild mucus or debris. This is modest but real.