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- Mild cramping (2-4 hours), light spotting (1-2 days), and brief dizziness are all normal side effects after an HSG test
- Fever above 38 degrees Celsius, heavy bleeding soaking a pad per hour, or foul-smelling discharge are warning signs that require immediate medical attention
- Most women recover fully within 24 to 48 hours and can return to work the next day
- Serious complications such as infection or allergic reaction occur in fewer than 1-2% of cases
- You can typically try to conceive in the same cycle after HSG, and some studies suggest a brief fertility boost
After completing an HSG test, many women wonder which symptoms are a normal part of recovery and which might signal a problem. The good news is that HSG is a very safe procedure, and most side effects are mild and resolve on their own within a day or two. However, knowing the difference between expected discomfort and warning signs can help you recover with confidence and seek help promptly if needed.
This guide covers every side effect you may experience after hysterosalpingography, from the common and harmless to the rare and concerning. We also provide a clear recovery timeline so you know exactly when you can get back to your normal routine, return to exercise, resume intimacy, and start trying to conceive.
Normal Side Effects After HSG
The following side effects are experienced by the majority of women after an HSG test. They are a natural response to the procedure and typically do not require any medical intervention beyond basic self-care.
Cramping (Lasting 2-4 Hours)
Mild to moderate cramping is the most common side effect after HSG. The uterus contracts in response to the contrast dye that was introduced during the test, similar to menstrual cramps. Most women find that the cramping peaks within the first 30 minutes after the procedure and gradually subsides over the next 2 to 4 hours. Over-the-counter pain relief such as ibuprofen or paracetamol is usually sufficient. A warm compress on the lower abdomen can also help.
Light Spotting (Lasting 1-2 Days)
Light vaginal spotting or a small amount of pink or brownish discharge is normal for 1 to 2 days after the HSG. This spotting comes from the catheter placement through the cervix and is not a sign of injury. A panty liner is usually all you need. The spotting should be much lighter than a normal period and should not contain clots.
Brief Dizziness or Lightheadedness
Some women feel momentarily lightheaded or dizzy immediately after the procedure. This is typically a vasovagal response caused by the cervical manipulation and is not dangerous. It usually resolves within a few minutes of resting in the recovery area. Eating a light snack and drinking water after the test helps prevent this.
Normal but Unexpected Side Effects
Some side effects can catch women off guard because they seem unrelated to a uterine procedure. These are still considered normal and are no cause for alarm.
Shoulder Pain or Upper Abdominal Discomfort
This is one of the side effects that surprises many women. If a small amount of contrast dye leaks into the abdominal cavity through the fallopian tubes (which is actually a sign that your tubes are open), it can irritate the diaphragm and cause referred pain in the shoulder tip area. This sensation can last several hours but resolves on its own as the body absorbs the dye. Lying flat and resting usually helps.
Nausea
Mild nausea after HSG can occur due to the vasovagal response, the cramping itself, or anxiety related to the procedure. It is usually brief and does not lead to vomiting. If you are prone to nausea during medical procedures, mention this to your doctor beforehand so they can offer guidance.
Watery Discharge
A clear or slightly tinted watery discharge is normal for up to 24 hours after the test. This is simply the remaining contrast dye draining out of the uterus and vaginal canal. It is harmless and nothing to worry about. Use a panty liner for comfort.
When to Call Your Doctor: Warning Signs
While serious complications after HSG are rare, it is important to know the warning signs. Contact your doctor or visit an emergency department if you experience any of the following symptoms after your HSG test.
- Fever of 38 degrees Celsius (100.4 degrees Fahrenheit) or higher, especially if it develops 1 to 3 days after the procedure, as this could indicate an infection
- Heavy vaginal bleeding that soaks through a pad in less than one hour, as this is not normal post-HSG bleeding
- Foul-smelling vaginal discharge, which could be a sign of infection developing in the uterus or fallopian tubes
- Severe or worsening abdominal pain that does not respond to over-the-counter pain medication
- Signs of an allergic reaction to the contrast dye, including hives, difficulty breathing, swelling of the face or throat, or a widespread rash
- Fainting or prolonged dizziness lasting more than 30 minutes after the procedure
If you experience any of these symptoms, do not wait to see if they resolve on their own. Early treatment of complications leads to much better outcomes.
Rare Complications of HSG
Serious complications from HSG are uncommon, but understanding them helps you make an informed decision about the procedure and recognize problems early if they occur.
Pelvic Infection (Approximately 1% Risk)
Infection is the most common serious complication of HSG, but it still affects only about 1 in 100 women. The risk is higher in women who have a history of pelvic inflammatory disease or existing tubal disease. Symptoms typically appear 2 to 7 days after the procedure and include fever, increasing pelvic pain, and abnormal vaginal discharge. Treatment with antibiotics is effective when started promptly. Some doctors prescribe prophylactic antibiotics before the procedure for women at higher risk.
Allergic Reaction to Contrast Dye
Allergic reactions to the iodine-based contrast dye used in HSG are rare but can range from mild (skin rash, itching) to severe (anaphylaxis). If you have a known allergy to iodine or contrast media, or if you have had a previous reaction to contrast dye during a CT scan or other imaging study, inform your doctor before the procedure. Alternative contrast agents or pre-medication with antihistamines and steroids may be used.
Uterine Perforation
Uterine perforation during HSG is extremely rare and is more commonly associated with difficult catheter placement. It may cause sudden sharp pain and is usually detected immediately by the radiologist on the fluoroscopy images. In most cases, a small perforation heals on its own without intervention, though monitoring is required. This complication is less likely when the procedure is performed by an experienced radiologist.
Radiation Exposure
HSG uses a small amount of fluoroscopic radiation. The dose is very low, equivalent to a few days of natural background radiation, and is considered safe. However, this is why the test is not performed during pregnancy. Always inform your doctor if there is any possibility you could be pregnant before the procedure.
HSG Recovery Timeline
Understanding the typical recovery timeline helps you plan your schedule and know what to expect each day after the procedure.
| Timeframe | What to Expect | Recommendations |
|---|---|---|
| Day 1 (Procedure Day) | Cramping for 2-4 hours, light spotting, possible dizziness or nausea, watery discharge from remaining contrast dye | Rest at home, take ibuprofen as needed, use a warm compress, stay hydrated, avoid strenuous activity |
| Day 2-3 | Minimal or no cramping, light spotting may continue, slight fatigue in some women | Resume normal daily activities including work, continue to avoid swimming pools, baths, and hot tubs |
| Day 4-7 | All side effects should be resolved, normal vaginal discharge resumes | You can resume all normal activities including exercise and sexual intercourse |
Most women feel completely normal by day 2 or 3 after an HSG test.
When Can You Resume Activities After HSG?
One of the most practical questions women have after HSG relates to when they can return to their regular routine. Here is guidance on specific activities.
Returning to Work
Most women can return to work the same day or the next day after HSG. If your job involves heavy lifting or strenuous physical activity, consider taking the rest of the procedure day off. Desk jobs and light-duty work can usually be resumed within hours of the test.
Exercise
Light walking is fine on the day of the procedure. More intense exercise such as running, weight training, or high-intensity workouts should be postponed for 24 to 48 hours to allow any cramping to fully resolve. Listen to your body and ease back in gradually.
Sexual Intercourse
Most doctors recommend waiting at least 48 hours after HSG before having sexual intercourse. This allows the cervix to close fully and reduces the small risk of introducing bacteria into the uterus. Some doctors may recommend waiting until spotting has completely stopped. Follow the specific instructions given by your treating physician.
Bathing and Swimming
You can shower normally on the day of the procedure. However, avoid soaking baths, hot tubs, swimming pools, and the sea for at least 48 hours after HSG. These environments could potentially introduce bacteria while the cervix is still returning to its normal closed position. Showers are perfectly fine during this period.
When Can You Try to Conceive After HSG?
Many women undergo HSG as part of their fertility evaluation, so this is one of the most important questions. The good news is that you do not need to wait long.
You can try to conceive in the same menstrual cycle as your HSG test. In fact, some research suggests that there may be a brief fertility boost in the 1 to 3 months following HSG, particularly when an oil-based contrast dye is used. One theory is that the flushing effect of the dye may clear minor debris or mucus from the fallopian tubes, slightly improving their function.
If your HSG results show open, healthy tubes and a normal uterine cavity, your doctor may encourage you to try conceiving naturally in the months immediately following the test before considering more advanced fertility treatments. If blockages or abnormalities are found, your doctor will discuss the next steps, which may include further testing or surgical intervention.
DCDC Aftercare: What We Do Differently in Dubai
At Doctors Clinic Diagnostic Center in Dubai Healthcare City, we believe that aftercare is just as important as the procedure itself. Our aftercare protocol is designed to ensure you feel supported throughout your recovery.
- Post-procedure monitoring period at the clinic before you are discharged, ensuring you are comfortable and stable
- Written aftercare instructions in your preferred language, including a clear list of normal vs. warning signs
- Direct contact line to our radiology team for any questions or concerns that arise after you leave the clinic
- Same-day results discussion with your referring doctor or our team, so you understand your findings immediately
- Follow-up coordination with your gynecologist to ensure a seamless transition to the next step in your fertility plan
If you experience any concerning symptoms after your HSG at DCDC, our team is available to assist you. For emergencies outside clinic hours, the nearest emergency facility is Mediclinic City Hospital, located within Dubai Healthcare City, or you can call the Dubai Health Authority emergency line.
Tips for a Smoother Recovery
- Take ibuprofen (400 mg) about 30 minutes before the procedure to reduce post-procedure cramping
- Arrange for someone to drive you home after the test, especially if you tend to feel lightheaded during medical procedures
- Keep a warm compress or heating pad ready at home for any residual cramping
- Stay well hydrated after the procedure, as this helps your body flush out the remaining contrast dye
- Wear comfortable, loose clothing to your appointment so you can relax afterward
- Plan a quiet evening after the procedure, even if you feel fine, as a precaution
- Avoid tampons for 48 hours and use pads or panty liners instead for any spotting
For a complete guide on preparing for the procedure, read our article on how to prepare for an HSG test. If you want to understand the full procedure before your appointment, our comprehensive HSG test guide covers everything from start to finish.
Need an HSG Test at DCDC Dubai?
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Final Thoughts
HSG is a safe and well-established diagnostic procedure with a very low complication rate. The most common side effects, including mild cramping, light spotting, and brief dizziness, are temporary and resolve within a day or two. Serious complications such as infection or allergic reactions are rare, occurring in fewer than 1-2% of cases, and are treatable when identified early.
The key to a smooth recovery is knowing what to expect and understanding the difference between normal post-procedure symptoms and genuine warning signs. If you experience fever, heavy bleeding, severe pain, or foul-smelling discharge after your HSG, do not hesitate to contact your doctor or visit an emergency facility.
At Doctors Clinic Diagnostic Center, we provide thorough aftercare instructions and remain available for any post-procedure questions. Your comfort and safety are our priority from the moment you walk in for your test until you have fully recovered. For information on procedure fees and insurance, visit our HSG test cost in Dubai guide.
Mga Sanggunian at Reperensya
Ang artikulong ito ay sinuri ng aming medikal na team at tumutukoy sa mga sumusunod na sanggunian:
- American College of Obstetricians and Gynecologists - Hysterosalpingography
- Fertility and Sterility - Complications of Hysterosalpingography
- Radiological Society of North America - HSG Patient Information
- Human Reproduction - Fertility Outcomes After HSG
- Dubai Health Authority - Patient Safety Guidelines
Ang medikal na nilalaman sa site na ito ay sinusuri ng mga DHA-licensed na manggagamot. Tingnan ang aming patakarang editorial para sa higit pang impormasyon.
Isinulat ni
Dr. Osama Elzamzami
Consultant Radiologist
MD, Radiology
Dr. Osama Elzamzami is a Consultant Radiologist specializing in diagnostic imaging including MRI, CT, ultrasound, and fluoroscopy procedures such as HSG at DCDC Dubai Healthcare City.