The aim of this study is to demonstrate the value of music in outpatient hysteroscopy on patients' level of pain and satisfaction. This may have a role in our daily practice in providing a better patient care in outpatient hysteroscopy.

Outpatient hysteroscopy is nowadays a commonly used procedure in Gynaecology in order to evaluate the uterine cavity and to diagnose different intrauterine diseases. It is a safe, convenient and cost-effective procedure in aiding the management of abnormal uterine bleeding. However, outpatient hysteroscopy can be associated with significant pain which would have impact on the woman's satisfaction and pain is one of the most common reasons for failure of the procedure.

Listening to music could be an easy and non-invasive way to reduce pain. A meta-analysis conducted on the effects of music on pain revealed that music interventions had statistically significant effects in decreasing pain on 0-10 pain scales. Researches on this topic in gynaecological office procedures, however, showed variation in the results. Some showed no positive effect of music on patient's level of pain, anxiety or satisfaction of patient or doctor for office hysteroscopy and colposcopy. On the other hand, some studies showed a positive effect of the use of music with a reduction of pain and anxiety during office hysteroscopy.

Inclusion Criteria:

• indication for hysteroscopy (abnormal uterine bleeding, abnormal findings on ultrasound, and infertility)
• signed informed consent
• ability to read Chinese or English.

Exclusion Criteria:

• hearing impairment
• known anatomical abnormalities which would make performing the procedure more difficult
• use of premedication for cervical ripening

The following individual participant data will be shared:

• Background characteristics including age, body mass index, occupation, religion, education, marital status, parity and number of vaginal deliveries and history of hysteroscopic surgery
• Details of the outpatient hysteroscopy including time, procedure and level of performing surgeon

The personal data will be kept for 3 years after the study. All the personal data will be discarded and destroyed after the storage period.

When a third party is interested to reanalyze study data or to combine data from multiple studies.

This is not a blinded study as both the participant and the care provider will be able to listen to the music if the subject is assigned into the music group.