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For the WomenFolk – Endometrial Biopsy

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.

“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 (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 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. 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…But apparently the considerable pain I experienced is actually quite common.  According to several other women:

“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.

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

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328 Responses

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  1. Mary Elizabeth Ramsay Marchese
    Mary Elizabeth Ramsay Marchese - at - Reply

    I had this procedure done two days ago and am absolutely LIVID. I was given no warning that it would be painful or to take any type of painkiller ahead of time (even Motrin). It was excrutiatingly painful (and was done at a practice where they KNOW I have a curved cervix). I have been googling this and have found a lot of women have had the same experience; one study says that 50% of women experience moderate to severe pain. So why isn't it routine practice to offer some type of strong pain relief? Some people don't have much discomfort getting a filling, but every dentist I've been to routinely offers novocaine. I have to go back next week to get the results and I am going to give them a piece of my mind. Am getting referrals for other obgyns and will make sure that I find one that will routinely offer pain relieve for any procedure that involves entering my uterus!

  2. Stefanie Peischl
    Stefanie Peischl - at - Reply

    Just had my surprise uterine biopsy today. Holy crap! Anytime there's an in-office biopsy, it's going to hurt, but I wasn't prepared for this. And I have a pretty high tolerance for pain. I had a white knuckle, sweaty grip on the sides of the exam table, cried out each time a section was scraped and suctioned, and was wobbly-legged afterward from tensing up. I'm surprised they didn't need to pry me off the ceiling. I took 2 Advil immediately afterwards (nothing but basic aspirin offered by the OB/GYN), and have been surprisingly fine. My caveat: I was menstruating so cervix was already a bit dilated (but not enough, so dilating instrument was still needed). I couldn't agree more that women need to be better prepped, and allowed to premedicate, if only with Advil 20-30 mins prior. Performing this procedure with no warning or pre-meds is just barbaric.

  3. Leonie Fairbrother
    Leonie Fairbrother - at - Reply

    had it done today. Worst experience of pain in my life! Wish I knew, could have taken something to help with pain. It is nuts how a woman is supposed to endure that. It took my breath away and I still feel unwell several hours later and I'm usually a tough cookie. Awful awful awful experience.

  4. Leonie Fairbrother
    Leonie Fairbrother - at - Reply

    had it done today. Worst experience of pain in my life! Wish I knew, could have taken something to help with pain. It is nuts how a woman is supposed to endure that. It took my breath away and I still feel unwell several hours later and I'm usually a tough cookie. Awful awful awful experience.

    1. Alexia Fairbrother
      Alexia Fairbrother - at

      Ouch! Can't believe that they didn't numb you first!!

    2. Alexia Fairbrother
      Alexia Fairbrother - at

      Ouch! Can't believe that they didn't numb you first!!

    3. Heather Burns
      Heather Burns - at

      take care your brave xxxx

  5. Mary Ann Barrett Reed
    Mary Ann Barrett Reed - at - Reply

    I had this procedure several years ago, and it was the worst pain I have ever felt. I was so shocked that they were doing this to me and I was awake. I swore I would never have this procedure awake again. We have since moved, and my new doctor wants me to have this again, due to my current symptoms. She told me to take a few advil first. Is she kidding? I have postponed it, but now I am afraid I am putting my health in jeopardy. I doubt my insurance would cover my having anesthetic. What can I do?

  6. Panna Montata
    Panna Montata - at - Reply

    Had two Coloposcopies (cervical biopsies) last year and it was indeed the WORST PAIN I EVER suffered in my life!
    Absolutely traumatizing! Nobody in this blog exaggerates the least bit!
    My doc said that not everybody's experience is alike. I guess those who don't have excruciating pain are simply extremely lucky.
    Got hold of some opiate containing pain killer prior to the second biopsy – but it merely made me care a bit less about the whole ordeal. It still hurt like hell AGAIN!
    Had kiddney stones once and this is known to hurt as much as childbirth. However, I prefer to have FIVE TIMES KIDDNEY STONES than another Coloposcopy.
    This week I just found out that I have to get an Endometrial biopsy (biopsy of the uterus).
    It looks like this is even worst! Decided that I will absolutely NOT do it without anaesthetic of some sort, peridural or whatever. This is possible if you go to a hospital rather than having it done at the doctors office.
    Am really glad I stumbbled upon this blog!
    THANK YOU to all of you who wrote down their experiences here.
    I already started being concerned and wondering whether I was some sort of hysterical asshole.
    Surprisingly there were some people out there whose mission is something called pain management…. but when it comes to endometrial biopsy / coloposcopy we are still in the middle ages.

  7. Tina Perry
    Tina Perry - at - Reply

    I had my biopsy done yesterday it was a breeze! Sure it pinched but nothing I couln't breath thru! I didn't have any bleeding of pain after.

    1. Debbie Chess
      Debbie Chess - at

      Hope all turns out well!!!!!

  8. Susan Meckel
    Susan Meckel - at - Reply

    I've had this done at least 6 times in the last 20 years, and will soon be scheduling another. I frequently spotted during my perimenoausal years, and have continued to do so since hitting menopause 11 years ago.

    My first two endometrial biopsies, done premenopausally, were uncomfortable but not terrible. I remember being baffled when the nurse offered to hold my hand during the second one. Ignorance is bliss….

    The next two, performed by a different doctor, were awful. The pain was much worse, and I was ill (faint and nauseated) immediately afterwards.
    Vasovagal response, probably. I had to wait in the office or the car about half an hour before I could attempt to drive home. One or both of those times, I was in pain the rest of the day.

    The next time, the doctor (yet another one) was unable to manuever through my narrow cervical canal. I was in too much pain. I ended up having a D&C instead. MUCH easier physically – but considerably more expensive, and signfiicantly more dangerous because of general anesthesia.

    I've had two biopsies with my curent doctor. Very painful – I refer to this procedure as visiting the torture chamber, even with Valium in my system – but the pain has subsided as soon as the procedure is over, and I haven't been ill afterwards. I do resent that this doctor doesn't "talk" me through the procedure, or answer my questions of "how much longer?" But – he saves me from repeated D&Cs.

    I've never bled more than mild spotting afterwards. The pain, for me, is much worse than childbirth…I never asked for pain meds during my long and difficult labor.

    A postmenopausal friend had an easy time with endometrial biopsy, while a premenosaual woman I know became ill from it. Depends on the woman, the doctor's technique, and the instruments, I assume.

    I am dreading going for my next endometrial biopsy. However, I personally choose the transitory pain, tortorous though it is, over the dangers of general anesthesia. I may change my mind in coming years.

    Many medical tests are painful. Bone marrow biopsies are reportedly agonizing, and patients normally get only local anesthesia for it, not knocked out. I have the impression that test is even worse.

  9. Rachael Marie
    Rachael Marie - at - Reply

    Just had this done… I screamed and went into shock. Worst experience of my life… pain-wise anyway. I will be asking for percocet next time. There's no way I can do that again without being SEVERELY under some sort of influence.

  10. Michael Radabaugh
    Michael Radabaugh - at - Reply

    I am recuperating from mine right now. No one warned me…how bad it will really hurt. My daughter's graduation is this weekend and I have so much work to do, but it hurts so bad, I can barely move. I am not a wuss and I have been crying all afternoon, thinking it was just the graduation, baby leaving the nest syndrome. I have had 2 kids with no pain meds and that didn't hurt as bad as this does right now. I would have waited another week if I would have known. Wish someone would have told me before…I am missing so many memories with my baby girl.

    1. Amy Keim Wenske
      Amy Keim Wenske - at

      So sorry. Let me know if there is anything that I can do to help out!

  11. Rebecca Lord
    Rebecca Lord - at - Reply

    I was dx with endometrial cancer about a year ago, and my husband and I made the decision to opt for the hormone therapy vs the hysterectomy at age 34 to try to preserve fertility. So far I have had two D&C's and two endometrial biopsies to check on how the therapy is working every 3 months, the last biopsy being today. Well I went in having cramps to begin with, so this time it was more painful. I sum it up to the procedure not being more than I could handle…..if it gets us to the point of having a little one, I will do what it takes :-)

  12. Magan Jane Bowhall
    Magan Jane Bowhall - at - Reply

    I had my procedure done three days ago. my doc had informed me that I would have an endometrial biopsy 2 weeks in advance, but since she didn't seem very concerned, neither was I. I have had two of my three kids without painkillers and have been run over by a pickup truck and none of that compares in the slightest with the pain from this procedure. what's worse is that the nurse practitioner attempted to do the procedure but was unable to open my cervix, and so I had to wait in the room until the doctor got out of an emergency c-section to make a second (successful) attempt. All in all I spent about 50-55 minutes getting the biopsy. I'm still cramping three days later. I didn't take any time off for the procedure and so I had to pull an 8 1/2 and a 10 hour shift while cramping, and feeling like my insides were going to fall out everytime I coughed. At one point during my bawling episode the doc turned to her nurse and said "Has she never had any cervical work done before?" like maybe it was something that I could have been conditioned toward. I was completely unprepared for the pain of this procedure. My plea is that any doctor reading this page please, please, inform your patients of the ridiculous amount of pain this "simple" procedure entails.

  13. Lauren Ziebart
    Lauren Ziebart - at - Reply

    I had a 'surprise' endometrial biopsy this morning too. 12 hours later I am still in pain. I had my daughter naturally with no drugs, a double episiotomy and forceps and the procedure this morning could have rivaled the pain. My doctor was wonderful, sympathetic and actually stopped halfway through because I couldn't take it. I think I'll be having it done in an outpatient surgery if the sample she was able to obtain is not sufficient. I felt the same emotions I read about here – like I was making too big a deal of it, and that it really shouldn't be that bad. But it was. Thank you for this article which I wish had reached me before so that I could have prepared. I hope the message gets out there for others.

  14. Pamela Adams
    Pamela Adams - at - Reply

    I TOTALLY AGREE ABOUT THIS PROCEDUE.TOLD ME THE SAME THING.IT HURT SO BAD I COULD NOT TALE IT ANYMORE.NOW I GET A PHONE CALL SAYING THEY HAVE TO DO IT AGAIN! WHY! WHO IN THE HELL WANT TO GO BACK THOUGH AGAIN.TEARS]

  15. Maxine Pierce
    Maxine Pierce - at - Reply

    It was the worst, and now, I'm having trouble urinating.. if its not better by the morning, I'm goin to calk the doc in the morning..

  16. Anonymous
    Anonymous - at - Reply

    I had one done several days ago and am still cramping. This is the second one in a month as apparently, my doctor didn't get the sample he needed the first time. I recommend taking Motrin before and after because it definitely hurts!! I felt like he had driven a Volkswagon into my vagina! I have 6 children-4 were natural, 2 were sections, so I am not a wimp. This hurt!!

  17. Swee Dee
    Swee Dee - at - Reply

    no one had my experience. i was in such intense pain i tightened up and the doctor couldnt get the thin tube through. i also have fibromyalgia. i am going for an ultrasound. you were all in pain,as i was, but at least you got through it, i didnt. it was horrible as you say. no one told me about it first, i really thought i could handle it. but i just could not take it.

  18. Jessica Hazel
    Jessica Hazel - at - Reply

    I had one last night for a pre-op appointment for a uterine ablation. I remembered the doctor saying something about needing to do a biopsy before the procedure, but she never said that she was going to do it in the pre-op appointment, and she never said that it was pretty unpleasant and that I should take something beforehand. I asked if I could exercise after and the doctor said sure, no problem. I was also told I was going to get a pad for the little bit of iodine that would leak out. Ha… That had to be one of the most painful things I have ever had done… and with nothing to dull the pain at all… And I've had kidney stones. I don't see how they think you can exercise after when you're cramping for hours following the biopsy. Also, I'm glad I had the pad, because I bled A LOT afterward. And I have a severely tipped uterus… so the clamping thing… I about punched the doctor after. Ridiculous. And they want to do the ablation while I'm awake as well… I don't know if I want that after what I went through.

  19. Pat Iddon
    Pat Iddon - at - Reply

    the pain I felt was unbearable during the test I asked the registra to please stop my request was ignored the nurse was behind the curtains offered no reassurance this is a barbaric test im appalled that this goes on

  20. Sandy Fitzer
    Sandy Fitzer - at - Reply

    I had one yesterday. Very painful. I wonder why they can't use something like the gas they use @ the dentist.

  21. Maureen Rada Tracey
    Maureen Rada Tracey - at - Reply

    I just had my endometrial biopsy this morning (2.10.14) and had to come back to this page — a page that has had me living in fear and with serious anxiety over the past 2 weeks — to report my experience. I have to say, I worked myself up for nothing. NOTHING. The procedure was hardly any more uncomfortable than a regular pap smear, and it was certainly not painful. I took 4 Advil about an hour before the procedure. The procedure itself took maybe 2 minutes. I am 40, delivered 2 children by C-section only, and thought having an IUD put in a couple of years ago was very painful. This was NOTHING. So to anyone who comes here and, like me, is totally freaked out by all the dramatic stories, rest assured that those stories don’t represent all of us. You have to take everything you read on forums like this with a grain of salt… No cramping, no bleeding, and went right back to work after the procedure. Piece of cake.

  22. Marie Culpepper Powers
    Marie Culpepper Powers - at - Reply

    I just had an endometrial biopsy last week and was quite nervous. I've had 2 C-sections but no vaginal births. My doctor prescribed medication that I took the night before and the morning of the procedure to dilate my cervix. I also took motrin a day in advance every 4 hours to get the pain medicine into my system. I distracted myself from the procedure by talking to the nurse. I had some pain and cramping but not that bad . It was a quick procedure and I had no cramping after it was over.

  23. Kris Breuninger Kowalski
    Kris Breuninger Kowalski - at - Reply

    Thank you so much for sharing. I didn't know I was getting one either until mid-appointment. I would recommend taking a friend or husband. I almost keeled over after when I sat up. It did sting. For me the worst was afterward. I'm two days out and still nauseated and dizzy. I have cysts on my ovary so everything is quite sore.

    The pain was like a very focused zing or strong cramp. Not something I care to experience again.

  24. Cindy DeVane Reynolds
    Cindy DeVane Reynolds - at - Reply

    I had about 6 of these over the past several years. Five of them felt like a bad pinch, but the 6th one felt like I was being killed. Seriously, I jumped up it hurt so bad. I wonder what makes the difference. Anyone know?

  25. Anonymous
    Anonymous - at - Reply

    I was totally freaked out about having my endometrial biopsy after reading all of the horror stories online. I almost cancelled the appointment a few times. I was having such bad anxiety that was having trouble sleeping and was waking up soaking wet with sweat. My husband told me it was important for me to have it for my health so I decided to do it. I did call the doctor about my anxiety and she prescribed a 5 mg valium and I took that with 800 mg of Advil. I can't believe I got myself so worked up about this procedure. It was not painful at all. Just some pressure and mild cramping. I have a very low tolerance for pain. I have to take vicodin to get my teeth cleaned. Please don't be afraid to have this procedure done. Just make sure you take something for the pain and you will be fine.

  26. Anonymous
    Anonymous - at - Reply

    I agree, crazy! At least now I no longer feel like I myself was crazy! I had this done a few days ago, like many others, without any warning. I am a tough woman but I found myself crying from the pain! It really felt BARBARIC! Didn't help that I had to go back to work afterward delivering mail in the hot sun on a walking route!

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