How exactly is a hysteroscopy done and is it painful? what if i also have to get a biopsy done during the procedure? ill be awake the whole time?

A "hysteroscopy procedure" can be painful , especially with an intended biopsy of the endometrium. Ask your GYN physician about doing a local injection of a caine derivative at "3 and 9 o'clock" on your cervix , which will greatly lessen any pain associated. General anesthesia is not usually necessary for these kinds of diagnostic procedures.