AbstractThis review summarises current understanding and research on the association between anxiety and outpatient hysteroscopy. Women undergoing hysteroscopy suffer from
significant levels of anxiety, with repercussions on pain per-ception, success rates and satisfaction. Using validated tool such as the Spielberger State-Trait Anxiety Index (STAI) o the Hospital Anxiety and Depression Scale (HADS) in the
outpatient hysteroscopy setting, average state anxiety scores similar or greater than those measured before more invasive procedures under general anaesthesia have been consistently reported. This clearly suggests a significant gap between our clinical viewpoint of what isBminimally invasive^and pa-tients’expectations. In spite of its potential role of confounder in studies on pain-reduction interventions, we found that pa-tient anxietywas evaluated in only 9 (13%) out of a sample of 70 randomised controlled trials on outpatient hysteroscopy published since 1992. Factors such as trait anxiety, age, indi-cation and the efficiency of the clinic can be correlated to state
anxiety before hysteroscopy, but more robust data are needed. Promising non-pharmacological interventions to reduce anxi-ety at hysteroscopy include patient education, communication through traditional or multimedia approaches, interaction and
support during the procedure and music listening.