Endometrial Biopsy

I am appalled and angered that so many women go through this very painful procedure without being accurately informed of what to expect.

It hurts. A lot.

Yet most doctors tell their patients that they’ll feel a mild pain. Most medical references also associate the procedure with a mild pain. Oh, they’re completely wrong.

“I had an endometrial biopsy yesterday.  I am still quite ill today.  I had more pain with this procedure than I have ever had in my life…and I’ve had two children, two elective abortions, 14 eye surgeries, an extensive breast biopsy, esophageal biopsy, lung biopsy, bilateral skin biopsies from my legs, sinus surgery and biopsy, and 14 periocular injections of corticosteroids.” – from http://stirrup-queens.blogspot.com

Initially, I wasn’t going to share this information with the World Wide Web, but after reflecting more on my experience, I thought it might be a good idea to put it out there, even if it only helps one other woman.

I had a “surprise” endometrial biopsy the other day.  It was a surprise because I did not know in advance of going to the doctor’s office that this procedure was going to be performed.  I was under the impression that I was going in to get results from my cervical biopsy and get checked out to make sure I was healing properly.  (Oh, and please don’t be worried about me – I’m fine, results were negative, all is well.)  So the doctor says she needs to biopsy my uterus because endometrial (uterine) cells had shown up in my cervix.  Which in some cases can be a problem.  I don’t think it’s a problem in my case, because I have absolutely no other symptoms of any kind of uterus problem.  But the doctor wanted to make sure.

So, for all you ladies out there, in case you ever need an endometrial biopsy done, I would advise that you

a.) find out why this procedure is necessary,

b.) reschedule a time to have it done instead of getting it done right then and there

c.) take painkillers beforehand.

The biopsy was a relatively quick experience, but definitely the most painful thing I’ve ever been through.  And afterward I felt embarrassed that I was “making such a big deal out of it.”  I felt that I should have asked the doctor for some time to do relaxation exercises.  I felt that I was exaggerating, that the pain couldn’t really be that bad, and that I was just a big wuss.

And then I did some research.

Now, here is what most doctors will tell you about the procedure:

The instruments may feel cold. There may be some pain as the cervix is grasped. Some cramping may occur as the instruments enter the uterus and when the sample is collected.

And here is what a woman who has had an endometrial biopsy has to say:

The biopsy is an outpatient procedure that only takes 10-15 minutes to complete. Before the biopsy you should take something for the pain, since the procedure isn’t performed under sedation. My doctor gave me the option to take 2 Percosets an hour beforehand. Two or three tablets of Motrin is an option if you don’t want to (or can’t) take something stronger.
The first stage of the biopsy is very similar to a normal PAP smear.

After you get comfortable in the stirrups, your doctor will insert a speculum. If your cervix isn’t at the right angle, your doctor will need to use a tenaculum to move it into position. This does hurt, because the tenaculum has pincers that grip your cervix and usually cause some bleeding. After that, your doctor will dilate your cervix and insert a Pipelle aspirator, which uses suction to collect the sample. You’ll feel cramping and then a pulling as the aspirator gathers its sample.

Now, not every woman has a terrible experience with this… especially if they are given pain meds beforehand, and we’re not talking 200mg of OTC ibuprofen – we’re talking valium or percocet.  But apparently the considerable pain I experienced is actually quite common.  According to several other women:

“They make it seem like it’s going to be as uncomfortable as having your eyebrows waxed, when as you described, my “whole body went into shock.” The kind of pain I experienced after was so deep inside my body, like nothing else I’d had before.”

“For me, the pain was searing and basically excruciating. The only “good” thing about this procedure is that it is kind of brief (though those few minutes do seem to last forever!). I was squeezing the nurse’s hand, grimacing in pain, and afterwards I was super woozy. Definitely felt like passing out just after it was over. Just had this procedure done this morning, and I’m still feeling a bit light-headed and sick to my stomach.”

My doctor was very sympathetic, and admitted that she had never had an endometrial biopsy herself, so she did not know what it felt like.  But she also told me beforehand that it would feel like “bad menstrual cramps.”  I was certainly not expecting the severe onslaught of intense pain that followed.  Two days later, I am still cramping, but more than that I am upset that so many women go through this very painful procedure without being accurately informed of what to expect.

An interesting article: Endometrial Biopsy Pain Is Greater Than Physicians Realize

Sadly, that article is from 2000, but it seems that most doctors have not gotten the message.  I will be discussing this with my own doctor, so that hopefully she will better inform other patients in the future, and give them some pain meds to take beforehand.

Not the most pleasant blog ever, but I do hope someone out there benefits from this.

*Update

We just want to thank everyone who has left a comment. We hope that this post, plus the experiences that everyone has shared in the comments section – continues to help inform women out there who are having to go through this procedure. Thank you.