Hello laszla, I've had hysteroscopy with biopsy on 3 occasions. First in my late 30s under general, but with laparoscopy & D&C carried out at same time & no lesser option for pain relief/sedation was offered.
2nd in my 40s with local anaesthetic & light sedation. This was by far the easiest of the three for me. I was conscious throughout, but relaxed & able to follow what was happening on the monitor. I didn't experience any pain, but as this one was carried out before peri began the access route will still have been relatively robust.
I don't get on well with general anaesthetic, so was very pleased to avoid it for that 2nd hysteroscopy.
My last was in mid-50s (postmenopause), without any sedation or pain relief other than the recommended 2 paracetamol an hour before. Though it was over quickly, I did find it uncomfortable (like intense period cramps), so would not recommend this option & you've sensibly already ruled that out. That said, it was undertaken at a time when I had poor absorption from my systemic HRT, so with low oestradiol levels (around 100) & inadequately treated VA, a combination that won't have helped comfort. I'm also a small woman, never had kids & cervical smears that were a doddle in fertile years had also become increasingly difficult.
I don't think they should routinely perform hysteroscopy on postmenopausal women without any form of anaesthetic (none was on offer for that last procedure) & I believe there was a campaign a few years ago to make it mandatory for women to be given choices on level of sedation & pain relief. It was obvious the lovely middle aged nurses were also not comfortable that patients at that hospital were no longer given any say in the matter.
I do remember posts though from some members a few years ago who had no problems with hysteroscopy without any pain relief or sedation at all.
If you feel you'd like to go along & let them attempt to do it under local so you avoid the GA you'd rather not have, then this seems a good approach. I'd tell the staff beforehand you are anxious, as we all are, as it's in their interests as well as yours that you are as relaxed & comfortable as possible. They will do all they can to put you at ease & likely tell you you can ask them to stop at any time. You can also ask them beforehand what your options are if you feel you don't want to continue.
I hope it goes well for you. Whatever you decide it is a quick procedure & after the 2 that involved hysteroscopy alone I was back to normal with no discomfort the next day.
Wx