Endometrial Biopsy

My wife is going in for an endometrial biopsy next week and I was wondering if any of you ladies had experienced one and what your thoughts are about the procedure...? Does it require sedation? Painful? Time consuming?

As a male nurse all I can tell you is that it is painful and requires mild/moderate analgesic. Not very time consuming if nothing goes wrong, and usually nothing goes wrong with a qualified physician. I don't think they are using sedation for this procedure at this time.

My wife had an endometrial biopsy performed at her annual exam by her gyno. She had changes in her cycle so he suggested the procedure. He said typically a woman would take two or three advils a couple hours before the procedure, but since she was there already they decided to do it without the pain medication. He told her it was not too bad and many women didn't take the pain pills. So she agreed.

I have never seen her in so much pain! And once I saw her break her arm.

To start with they use a tool to hold the cervix in order to get the canula in. I think it is called a tenaculum. it is a scissors like device with sharp points on the two tips. They are the size of the tip of a sharpened pencil. And shaped just like the sharpened portion of a pencil. They puncture the sides of the cervix with those points to hold it still.

She screamed and pulled back on the exam table and her face was grimaced like i have never seen before. She tried to pull away backing up on the table on her elbows. but it looked like the doctor pulled her back down to the end of the table with this torture device piercing her cervix.

Then he used several sounds to dilate her cervix before putting in the canual. She cried throughout the whole procedure.

They found nothing.

I had one during fertility and its was painful. It was painful during a week.

Good luck to your wife. I hope all goes well and it’s nothing bad. Yes it’s painful. Quite. Be nice to her and take care of her after. It’s not debilitating or anything just very unpleasant

For the life of me, I don’t understand why docs don’t think this warrants some sort of sedation and pain management.

Rest assured if some doc had a tenaculum attached to his testicles, he would quickly reconsider.

@XposeHer sounds like a horrendous procedure involving great vaginal pain

Good God, how about a local at the very least!!!

They did use a local anesthetic, and the shots into her cervix were maybe the most painful part of the proceedure.

The doctor said if they had more time he would have given her something to take at home, but he didnt since she was already there and they didnt have that much time to wait.

And from reading i have learned that how women “tolerate” it--that is their euphemistic way of saying how frickin painful it is--is variable. Some women dont have that much pain from this proceedure, and some do.

So i dont blame the doctor. entirely. its just painful.

For the life of me, I don’t understand why docs don’t think this warrants some sort of sedation and pain management.

Rest assured if some doc had a tenaculum attached to his testicles, he would quickly reconsider.

And, if not handled properly, a tenaculum can and will tear out organs, I have heard of it happening from someone who saw it happen. I agree, if men had menstrual cramps, we would have a better solution to them by now. But there's this inculcated attitude to deal with. Women's pain isn't taken seriously sometimes and it's an attitude that needs to stop.

Should I encounter it in the wild, I will say stop. If that is not respected, 2 things happen, collectively known in the field as the referral kiss of death. I write a letter to the practice manager informing them of what happened, why I will not be returning as a patient and enclose the completed papers to transfer all records to the referring provider, and the referring provider is informed of what happened.

I've seen it work out in patient's favor more than once, so never hesitate to speak up.

Rest assured if some doc had a tenaculum attached to his testicles, he would quickly reconsider.

So are you suggesting that female doctors don't use a tenaculum when it is required for an examination?

Not at all. Sometimes there are procedures that are unpleasant but necessary. Those painful procedures should be met with pain management. I mean, let’s think about this for a second.

An endometrial biopsy is generally done with little to no pain management. I’ve heard many women say that they were told to “take some ibuprofen” before the procedure. If a male were told the same thing before his vasectomy, people would lose their minds.

I understand that the procedure needs to be done. I just feel that pain management for women undergoing gynecological procedures is many times an afterthought.

@funnorfolkguy you are correct. I saw stars when they dilated me for my IUD. I have heard the endo biopsy is awful and I can't behind they wont just twilight sedate for it. Women's pain really isn't taken seriously.

I’ve had two, before my hysterectomy, and neither was too bad. They were pretty fast, under two minutes, so I think it’d be hard to sedate for. It was definitely uncomfortable but I’d put it at maybe a 5/10 on the pain scale, and again, only for those few minutes. Then again, I’ve been told I have a high pain tolerance, so maybe I’m not the one to judge based on?

I’ve had them under general anaesthetic and then policy changed and they did it stone cold sober. I couldn’t cope with the pain and they eventually booked me in for day surgery

I am very surprised by all these negative reactions.

Certainly an endometrial biopsy is not particularly pleasant but, if it is well carried out, there is not the pain described on your posts.

This gesture is part of a complement that can be carried out in the gynecologist's office, without anesthesia.

The placement of a Pozzi forceps to hold the cervix is ​​not essential and, if necessary, should not be too painful if it is well placed (on the commissure of the external orifice of the cervix).

As far as I am concerned, if the cervix is ​​easy, I insert a very small diameter cannula (abortion cannula type) and when I feel that I have reached the inside of the uterus, I do 2 or 3 rounds. return to collect endometrial material.

The ideal is to take the sample in the middle of the cycle, just before the bleeding. The uterus can also be penetrated with a cytology brush usually used for endocervical sampling.

After the operation, some residual bleeding can be observed and the patient feels some cramps that she can alleviate with the medications used during her menstrual pain.

Gynecology is an anxiety-provoking specialty for the patient, the practitioner should be the most understanding and gentle in his practice.

While true that some experience only minor discomfort I'm not at all surprised by numerous negative comments. You'd get the same reactions from the same women if the procedure was an IUD placement. Some tolerate it better than others. There are a couple techniques used with tenaculum placement, if that is used, either the slow close or the cough method, but in pain studies both are pretty much equally painful. The second issue is the cramping that comes with anything passed through the cervix…it's going to vary from period type cramps to very severe cramping for some. The problem is the doctor whose knee jerk is to say oh well take a few ibuprofen and you'll be just fine vs using intrauterine or cervical anesthetic or paracervical block. It's a sort of lame assumption that all women will experience the same pain level which is just plain silly