Why does tubal contrast examination hurt for some people while others don't?

Patient's question:

I want to have a child with my husband, but after three years of marriage, we still haven't been able to conceive. Later, we went to the hospital for a thorough check-up, and the doctor suspected that blocked fallopian tubes were causing infertility. He recommended an hysterosalpingogram. However, I was afraid of the pain, so I asked the doctor how it felt. He said it was okay and that most people could tolerate it. Later, I followed the doctor's advice and had an hysterosalpingogram. The bloating and pain were so intense that even thinking about it now makes me hurt. But some people feel fine after the procedure. Why is it that some people experience pain during an hysterosalpingogram while others don't?

Doctor's answer:

Whether tubal contrast is painful still depends on factors such as the doctor's proficiency and whether the patient is cooperative. If the patient is not very cooperative, the doctor's skill is not up to par, or the patient already has adhesions and blockages, there may indeed be a recurrence of mild pain. Based on clinical experience, tubal contrast generally does not cause significant pain, although a small number of people may feel discomfort.
How painful a tubal examination is varies from person to person, as their pain perception differs. Most women may find tubal contrast to be a relatively painful examination, but it is usually within the range that they can tolerate.

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