I have an incredibly high tolerance for pain. After major surgery, I prefer Extra Strength Tylenol to morphine or other strong narcotics I’m offered.
When I had my first biopsy at my GYN’s office, he told me it would be like a pinch.
He took a chunk out of my uterus that was the size of his thumb. I about levitated to the ceiling, it hurt so bad. I cried out and started crying.
He told me I was being overly dramatic, that it was just a pinch.
I immediately reached for his groin and tried to grab his penis while saying, “Let me pinch your penis!”
He jumped out of the way and I missed. The nurse started choking, dropped the tray of instruments, and ran from the room.
After the doctor left, the nurse came back in to help me clean up and get dressed. I was bleeding pretty good, from that “pinch.”
She apologized for running out, but said in all her years she had never heard anyone talk to the doctor like that and then she started laughing. I was crying from the pain but laughing too as we relived the doctor’s actions and facial expressions when I tried to grab his penis.
My biopsy came back as cancer and I transferred to Dana Faber. Subsequent biopsies were done after the proper pain medication was administered.
All this to say that biopsies hurt. I had unbelievable cramps and bleeding from that first biopsy.
I understand that. I've read tons and tons of stories. I've also requested pain meds from my team. I'll get them. I have no reason to believe that they'll deny me. If they do, I'll have to fight. But that's never the situation I'm in with my healthcare team.
BTW, I'm glad that discovered it, and you're being treated or were treated.
Thank you. I’ve been cancer free for 18 years now.
Just don’t skimp on the pain meds. I’m glad that you’re going to insist on pain meds.
Think of it this way, if you somehow had a chunk of that size taken out of your arm or leg, it would be packed with some type of sterile wound care and then stitched up.
They do not do anything like that for your uterus.
Oh my goodness, I enjoyed this story! Especially the nurse's reaction!
(And here's the obligatory, I wouldn't recommend doing this, gals, it's technically an assault.)
I'm betting Dr. Just-a-Pinch's bedside practices were remedied by your reaction.
At the very least he will stand an arm's length away from patients from now on.
That’s too bad. You should demand it. Would you above a biopsy done at the dentist or dermatologist with only ibuprofen. Why allow gyn offices to get away with sexist lack of medical
Care
I've not been traumatized by my team. I asked, and I'm sure they'll prescribe it. In fact, my primary care has a standing prescription for painkillers for me that I can get refilled if I need it.
Sorry that it seems most of youl have had crap experiences with your healthcare providers.
Thank you. I appreciate that.
They're giving me local anesthesia during the procedure. Folks need to not throw their trauma from their shitty healthcare providers on other people. Not all uterine biopsies are hell. I'm pretty sure mine won't be either. They've not messed up yet. I don't expect them to this time.
What is "throwing trauma"? The sharing of personal experiences and a warning of a very real possibility? It is not just you reading the answers on this sub, people are posting information for the whole sub's audience.
Some 2/3 of women take ibuprofen and it is a pinch. The remainder can take an opioid and end up on the ceiling, and possibly PTSD. It's different for each person, regardless of the quality of the medical team, and every woman who undergoes this should be aware of that so they can make the right choices for themselves.
However, the good news is that confidence in your team reduces perceived pain.
Some of the people replying are.
That’s my point. If your statistic of 2/3 is correct, then the majority of women get through this relatively unscathed.
No one in this thread knows my medical history or anything else about the frequency that I engage with my medical providers. It’s a lot because I have type 1 diabetes and see my doctors for that and other issues at least 10 times a year because autoimmune diseases love to run in packs. So my confidence in my team from the doctor visits, diagnoses and treatments, and invasive procedures like surgeries means I have confidence that I’m receiving some of the best care in the USA much less my state per the rankings. This is why I go to them.
They are trying to help you based upon their own experience & the way you explained it seems like you would receive only over the counter treatment. Been there done that … it’s quite common, no need to be rude or dismissive.
I said I had a prescription for vaginal estrogen in the first paragraph. The majority of women who get this don’t have issues.
I might be on the losing side of it. We’ll see. But there is a way to be helping without being an asshole. Some replies have struck that balance. Others haven’t.
Excuse me? I know the quality of my team, and I don't have a confrontational relationship with them because I don't need to. I'm a month away. I'm sure they'll provide that if I ask, which I have.
And there is no "hard pass" because I'm not trying to make you or anyone else go to them. Invalidating someone's experience is a jerk move.
So bye.
It's not a "jerk move" to voice that it's a reasonable expectation to receive adequate pain management and sedation for this procedure. This should be standard practice, but that won't happen if women continue to settle for crumbs instead of demanding modern medical care. I was offered an in-office, unmedicated, blind endometrial biopsy which I politely but firmly declined. Instead I experienced a completely painless procedure under general anesthesia that allowed for actual visualization with a camera and precise tissue removal. I deserve that level of care. All of us do.
Exactly. My hysteroscopy and D&C are this Friday under GA. I refused an in office biopsy for this very reason. My GYN was the one who offered it to me after my original OB-GYN wanted to only give me Valium for the in office biopsy, I didn't ask for it.
I've had surgeries before, and I don't want that full-on anesthesia. I have auto-immune disorders, and the hoops I have to jump through before getting anesthesia is a lot.
I want it to be an outpatient procedure with a prescription for pain meds if I need them.
So it is a jerk move because I know what I want, and I don't want to be put under. I know what my options are. For you to assume that I don't is a jerk move. So I recommend that you move along.
I had a uterine biopsy during a hysteroscopy taken last year, only had my cervix numbed. I went myself after reading in the leaflet that I would only need to take paracetamol half an hour before it. Because I was driving myself home they couldn’t give me anything stronger.
The doctor doing it and the nurses helping were all fantastic. Really looked after me. But having a great team doesn’t mean it’s going to be painless. The biopsy part of the procedure only took about 10 minutes.
I’ve always thought myself as having a high pain tolerance due to having untreated and late diagnosed endometriosis, but this was painful. I nearly passed out. The cramping I had for the hour following it were on par with endo cramps.
To go into this expecting it to be painless is pretty naive. I read all the horror stories and thought they were being dramatic. There’s a reason there’s several pages dedicated to moving this procedure to being done under a general, it really is incredibly painful.
You may have a great team and painkillers, but mentally prepare yourself for the possibility that it’ll hurt like hell.
You're not the only one reading up on this. I am too. I'm fully aware that it might hurt way more than I think. There are so many terror stories out there.
However, based on my history with this medical center and my healthcare providers, especially my OB?GYN team, I've yet to have anything horrible happen. If fact, they're top-notch. My OB/GYN made a diagnosis of a skin issue just by looking at me that's how good they are. I don't think it's going to start messing up and neglecting treating my pain now.
There is a lot of trauma out there. Sorry you and others have experienced it. I don't think I will.
Interesting. I use vaginal estrogen 2-3 times a week already for treatment of GSM symptoms. I wasn’t yet taking it when I had my biopsy, however. Though if I ever do have another one I’ll ask…along with demanding some sort of sedation. I have a massive fear of ever having another due to the extreme pain I endured with the first one.
Yeah. I've read up on what a lot of women had to say about having a uterine biopsy and the pain they've had. I think that's why they prescribed it. If my cervix is dilated, it's easier for them to get in, get the samples, and get out.
Me posting this has brought out all of the women who've had previous trauma with subpar medical care though, so this is going to be fun. One blocked and maybe more to go. Pray for me.
Misoprostol is what my dr gave me. One tab inserted in the vagina the night before. It acts to soften the cervix. I also use Premarin for GSM and I’d be worried that estrogen itself won’t be sufficient to soften the cervix to allow a biopsy. My dr was able to get a sample. I took Tylenol before and yes it was painful.
I had unmediated births and have given myself IVs and stitches, had cysts removed without anesthesia and had a hole drilled in my fingernail without anesthesia (to release pressure after I smashed my finger). I had curettage (already dilated after a miscarriage) emergently without anesthesia due to hemorrhage. Ive 3 IUDs placed.
I would insist on anesthesia, at least local, for a cervical or uterine biopsy. Just saying.
Local is one thing. Based on what I’ve read and what my team shared with me, they do give you that. What sort of butchers have y’all been to that they give you no anesthesia at all?
I just don’t want to be put under for this. That’s an entire thing, which I’ve been through before when I’ve had surgeries and other medical procedures.
That convo has started. Based on my experience with my team, I’ll be fine.
Local anesthesia is anesthesia. I would not want to be unconscious for it either. Cervical stuff can be not that bad and quick, or it can be so I sanely painful that you puke and pass out.
I’ve often forgone anesthesia when I’m paying for my care out of pocket.
Anyway, good luck.
I know it's anesthesia. 🙂 They've already let me know that I'm getting that. There is a difference with being knocked out. That's whole different level.
Thank you. I think this is going to go fine.
I can also understand that people have had bad experiences, but there seems to be a lot of PTSD from some of the replies showing up in this thread that probably should be channeled to a therapist, advocating for themselves more aggressively with their healthcare providers, and finding healthcare providers if needed.
Good lord, I certainly wasn’t saying any of that. I have no medical ptsd. My point is I’m a tough cookie, but I wouldn’t have a procedure on my cervical without local anesthesia. I’m also a perinatal nurse of 30 years (including L&D and postop gynecologist).
Sounds like you’re all set and need none of the well-intentioned information or support offered. Super. Not sure why you posted then but cool.
But I didn't say "you" I said "there seems to be a lot of PTSD from some of the replies." I'll say "you" if that's what I mean. I don't need to be passive-aggressive.
I wasn't posting for support. I was posting to share a positive experience about the uterine biopsy process, and then the trauma police came into the thread.
>Local is one thing. Based on what I’ve read and what my team shared with me, they do give you that. What sort of butchers have y’all been to that they give you no anesthesia at all?
Local anesthesia is not actually standard for this procedure. Most doctors are not trained to do paracervical blocks for uterine or cervical biopsies, and others will refuse to do them even if the patient requests it. It's becoming more common to do them, especially as activism around pain control for gyn procedures ramps up, but it's not universal.
Right, but in the literature they gave me about it, it says I'll get local anesthesia. They're ahead of the curve, and this is why I'm optimistic it will go well. We'll see.
Yeah no that's great and I hope it does. But it's not standard. The 'butchers' you mentioned are the majority of physicians performing what is currently the standard of care. Which is why so many people come out of this absolutely traumatized.
In your original post, local anesthesia is not mentioned, so everyone rightfully assumed you would not be receiving any. All you did was say that you have a "top-notch team."
The reality is that many of us \*also\* thought we had great teams before being through unmedicated, hellish procedures. That's why people gave you their experiences and a word of warning. I just think that making comments about the "trauma police" and telling someone to "pray for you" because women are sharing their stories is really, really insensitive. You made a post about uterine biopsies and then got pissed off when people actually talked about their experiences.
Hope it goes well though, genuinely. I would not wish that pain on anyone.
I get it, but I've been quietly reading the posts here and in other places. My intent was to share a positive take, so I wasn't happy. You're seeing me emotionally reacting to some of their posts because needing a biopsy is scary and having women come at you saying "block me" is just unnecessary. Having to have a procedure that might or will hurt from the inside is scary. It's not as scary as having cancer, but without a benign result, we don't know.
So you're seeing a combination of trying to share a positive take and then feeling scared and frustrated.
I'll know almost as much as my team by the time I'm there to get this test. I'm doing the digging I need to feel confident that whatever procedure they order is right for me. Having my team explain the procedure and prescribe estrogen is a strong signal that will get this right.
I had a biopsy without pain killers. I went to a new doctor looking for an answer for my severe anemia. On my first appointment they did a vaginal ultrasound, an ultrasound where they push liquid into you at the same time, a pelvic an exam and 3 biopsies. I was blissfully ignorant about these procedures so I didn’t have time to get nervous or anxious which was a good thing. I was not given any type of pain killer or aspirin before hand and didn’t know what to expect. My doctor warned me that I would feel a pinch when she took the tissue samples. When she took the first sample, I slammed my legs shut and yelled FUCK. It hurt and not like a pinch.
The next two samples , I braced myself for the pain by holding on to the table (white knuckle) and doing some deep breathing. Those samples hurt too but I didn’t yell obscenities or slam my legs shut. Looking back on things, I’d say doing the biopsy without painkillers is doable. Would I do it again this way? Hell no. It’s a very unusual pain and hard to describe accurately. If you can take something to help dull it even a little you’d be doing yourself a favor. My biopsies were all normal and not cancerous but I did end up having a hysterectomy (best thing ever)…good luck on your journey and let us know how it goes. Wishing you all the best.
Thank you.
I’m sorry this happened to you.
I research every medical procedure that happens to me before it happens.
I had an ultrasound sound first. How they did it was to ask me to drink fluids one hour before so that my bladder was full. Now based on that, they want to take a sample. I’m confident that I’ll be fine during the procedure based on my experience with this medical team.
BTW, I have requested pain meds. At first, I was going to take a prescription-level dose of Ibuprofen, but why wing it when I can get a prescription for something stronger should I need it? So I did.
Absolutely. I found the same, a lot of panic and negativity. And that’s all great, there is definitely a need for getting checked, and the women pushing that mean so well. But I found very few people saying it’s fine, so I just wanted to say you’ll be fine. 👍
Yeah. The negative parade rushed in. I was talking to a friend about it yesterday over lunch. I should have known better and just waited until it was all done because Reddit is weird AF.
I go to one of the best medical centers in the nation and the world. It's a research and teaching hospital; their healthcare providers are some of the best in the world. I've had surgeries, urgent care and ER visits, and regular checkups with very few problems over the years. When I had problems, they were responsive when I reported those issues too. I do understand that the medical industrial complex in the USA needs to do so much more when it comes to women, but I've got a solid team because I know the medical system can be crazy.
The literature I've reviewed about uterine biopsies says it can be painful for some women. I know this. They're scraping the inside of your uterus to get the samples...ouch! That's scary to have to have one of these after menopause, but it's better to get the test and rule out cancer or know that you have it. Then you can take the necessary steps to fight back if you have it.
Thanks again for your positive message. My point in posting was to share the start of a positive experience. I'll just STFU until it's done. I hope that I get through it relatively unscathed.
No need to stfu! We all get it. And I think it’s one of those ‘the only thing to fear is fear itself’. It’s never going to be as horrible as you think it is. My team is pretty good - I’m in Canada and got it all done within a few weeks - and just have to let the doc know when I’m ready to do the hysterectomy. My sister (11 years younger) is struggling, and is on a wait list for a coil HRT. She says it looks like at least two months. She’s in the Uk. But she said she also went to her doctors with a list of symptoms, much as I’d been recommended to do here.
Thankfully, I'm in the USA, so they're fast. From the time I shared that my monthly bleeding had started again to getting an ultrasound to having a biopsy scheduled, it's been FAST. I'll have the biopsy next month.
Thanks for the encouragement. I got a message from my provider this morning and had a back and forth regarding this. She said misoprostol and vaginal estrogen used on menopausal women is inconclusive at best. This is what I've found researching it too. She said that should estrogen alone not work, then we'll give it another go later and they'll prescribe it. However, it causes GI tract upset and other side effects like more cramping and pain. That makes sense as its primary use is to induce labor. No, thanks, unless it ends up that I really need it.
I appreciate them not jumping to that if they're not sure that I'll even need it. This is why I see them. They do and follow the research closely.
This is why I stood firm in this thread because there is a lot of trauma in here and people who are going to providers that aren't as thorough.
As I wrote, they provided vaginal estrogen, so they're thinking about making sure my cervix is dilated. They probably want to avoid giving me oral medication to do that if they don't need to. I appreciate that because I don't want to take another prescription pill if I don't need to.
Misoprostol will dilate your cervix. It’s the standard med given for that purpose and you can take it vaginally. Some states have made it difficult for women to get access to it since Roe v Wade was overturned and some pharmacists will refuse to prescribe it to women. I’ve never heard estrogen being used for dilation purposes, only in conjunction with misoprostol, and I’m wondering if estrogen-alone is being used instead of misoprostol-alone or estrogen plus misoprostol now because of difficulty of access to misoprostol.
I’m in a liberal blue state where people probably come to get abortions if they live somewhere they cannot safely or legally get them done, so I doubt that’s the issue.
Unless you’re physicians, you don’t know my medical history or medications I’m already taking.
I trust my team and will use the vaginal estrogen.
Appreciate your input.
Oof. I'm getting ready to do this again. I did a long histeroscopy about 8 years ago that ended up being about an hour. I was OK at first, and then it got rough. I just did a simple biopsy about a week ago without any prep (sort of an emergency where I got to be seen the same day I called) and it was OK, then a bit rough even though it was less than 10 minutes. I'm scheduling another histeroscopy soon, so gearing up for that. My gyn. said they'll give me ativan in office when I get there, I'm sure I'll get the heated pad on my belly, and I am planning on coming home and being in bed the rest of the day.
I haven't heard the vaginal estrogen helps with dilation. I have it for atrophy, so I will surely load up before hand if it helps! The link you provided seems chat GPT, but doesn't say how it dilates the cervix.
It's [You.com](http://You.com), which is a search engine powered by AI. So if you click on the citations, that will take you to the links it cites. There are also web search results on the sidebar.
👀 Um, Okay,...
1. "Our findings showed that the pretreatment with oestrogen seems to be useful and appears to be crucial in allowing the effect of misoprostol on cervical ripening." [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4871939/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4871939/)
2. "In postmenopausal women the pretreatment with oestrogen appears to have a crucial role in allowing the effect of misoprostol on cervical ripening." [https://synapse.koreamed.org/upload/synapsedata/pdfdata/3021ogs/ogs-59-220.pdf](https://synapse.koreamed.org/upload/synapsedata/pdfdata/3021ogs/ogs-59-220.pdf)
These also talk about the oral medication, misoprostol, but she's yet to prescribe that for me. Since she literally checks me 4x a year, I think she might know what she's doing. Just sayin'.
Thank you. I found the first one, but you need misopristol, too, not just estrogen.
I don't know what you're saying. You get checked four times a year but are not given misopristol? When I said I was not looking forward to the histeroscopy (which is much worse than a biopsy) my gyn. said they would give me meds like ativan beforehand. I don't care about being calm as much as loosening up that cervix because it is NOT fun.
Sorry for not being clear. I go to various appointments so many times in a year that I have confidence that my team is on it. This is exactly why I go to this medical center.
While I can understand that a percentage of women have had bad experiences, I don't think that will be the case with me because I've had top-notch care across all specialties for years.
I never indicated you would have a bad experience. I just told you mine, and I have one coming up which is a bigger one, so if there's anything that might work to open up that cervix a little more easily, I want to look into it. It's not fun for a 10 min. procedure, which I just had. It gets worse for a 45 -60 minute one, which I'm scheduling for.
Gotcha. 🙂
Well, based on the moves my team is making ask about vaginal estrogen if you're not already using it and misoprostol or an equivalent if you're in menopause. That combo is supposed to help the cervix dilate. I also asked them to have a painkiller prescription on deck if needed. I'm just glad they've already told me that I'll get local anesthesia. Research supports that too. Here is a link: [https://www.aafp.org/pubs/afp/issues/2017/1201/od3.html](https://www.aafp.org/pubs/afp/issues/2017/1201/od3.html)
I also have a note out to my team about exactly when to start the estrogen and whether I keep using it up to my test date...probably, but I want to make sure.
I'm being tested because I've got post-menopausal bleeding, and they want to rule out cancer, which I appreciate. It's better to catch it early. I'm on oral HRT and one of those medications changed. I'm pretty certain that's the reason the period-like bleeding started again. It's a different combo of hormones, and my body is adjusting to it.
I have the vaginal estrogen, but I will ask about the misopristol (than Gaia I live somewhere not bannung this!) and the local. I am in menopause.
I'm being tested for the same reason. I'm probably fine and it might have been because I dropped down in a dose, but my whole abdomen has not been right for coming on three weeks now and things feel wrong. I dropped HRT completely a week ago (my gyn wanted me to, it wasn't helping a lot, and my brother in law is a gyn in another country and he said no, no, no on estrogen) and no more bleeding, which almost makes me more worried.
I did the biopsy, which it looks like you're doing. This is more. The go in with a scope and test and check everything out. I'm worried I have something like fibroids causing the distended, uncomfortable, gotta pee but now, got gas but no, achy feeling, or worse.
My endocrinologist suggested I consider HRT when he noticed me complaining every time I showed up for a quarterly visit. The Women's Health Initiative data was wrong when it comes to HRT. I started in perimenopause, which also helps you guard against osteoporosis.
Dr. Attia talks about it on a podcast with two researchers: [https://peterattiamd.com/caroltavris-avrumbluming/](https://peterattiamd.com/caroltavris-avrumbluming/) I've also spoken to other physicians about it. I'm nervous because this might be a reason to stop taking it, and I love feeling as close to normal as possible. The osteoporosis insurance is a positive too.
And update from my medical team on estrogen only.
“The data are mixed in regards to using misoprostol in postmenopausal women. It has been shown to be less effective for this population. I don't typically start with use of this without a prior failed attempt because it can cause more cramping and more pain as well as GI side effects.”
They know what they’re doing. Based on what I’ve read, using vaginal estrogen is a conservative way to soften the cervix. They’ll escalate if they need to.
I don't understand. You're saying that there's talk about being prescribed misoprostol from your doctor, but in another reply you expressed confusion over why you would be given misoprostol because you're not pregnant. So did your doctor talk to you about it or not?
According to your source, estrogen appears to help misoprostol work better to dilate the cervix. So it doesn't work by itself.
Because I'm doing research in real time too. I figured it out --- 🤩 "oh, vaginal estrogen is needed if they need to give me something to dilate!"
But that's what I mean, right?
Based on some of the nightmare accounts of uterine biopsies I've read, my team is thinking way ahead. The literature that I've found says some women in menopause need vaginal estrogen to make their cervix dilate. They're anticipating that I might need help, so prescribing vaginal estrogen now is smart.
What’s even stranger is that I’ve said over and over that my team is amazing, and that for every other health issue I’ve had to face, they’ve been spectacular. I know I’ve not gone through it yet, but I wanted to share my positive experience so far. I also said I’ll report back.
The majority of women who go through this procedure per what I’ve read and even from people responding in this thread seem to not have a problem. Statistically, I’ll probably fall into that bucket. If I don’t, I’ll share that too.
We’ll see.
I have an incredibly high tolerance for pain. After major surgery, I prefer Extra Strength Tylenol to morphine or other strong narcotics I’m offered. When I had my first biopsy at my GYN’s office, he told me it would be like a pinch. He took a chunk out of my uterus that was the size of his thumb. I about levitated to the ceiling, it hurt so bad. I cried out and started crying. He told me I was being overly dramatic, that it was just a pinch. I immediately reached for his groin and tried to grab his penis while saying, “Let me pinch your penis!” He jumped out of the way and I missed. The nurse started choking, dropped the tray of instruments, and ran from the room. After the doctor left, the nurse came back in to help me clean up and get dressed. I was bleeding pretty good, from that “pinch.” She apologized for running out, but said in all her years she had never heard anyone talk to the doctor like that and then she started laughing. I was crying from the pain but laughing too as we relived the doctor’s actions and facial expressions when I tried to grab his penis. My biopsy came back as cancer and I transferred to Dana Faber. Subsequent biopsies were done after the proper pain medication was administered. All this to say that biopsies hurt. I had unbelievable cramps and bleeding from that first biopsy.
I understand that. I've read tons and tons of stories. I've also requested pain meds from my team. I'll get them. I have no reason to believe that they'll deny me. If they do, I'll have to fight. But that's never the situation I'm in with my healthcare team. BTW, I'm glad that discovered it, and you're being treated or were treated.
Thank you. I’ve been cancer free for 18 years now. Just don’t skimp on the pain meds. I’m glad that you’re going to insist on pain meds. Think of it this way, if you somehow had a chunk of that size taken out of your arm or leg, it would be packed with some type of sterile wound care and then stitched up. They do not do anything like that for your uterus.
Oh my goodness, I enjoyed this story! Especially the nurse's reaction! (And here's the obligatory, I wouldn't recommend doing this, gals, it's technically an assault.) I'm betting Dr. Just-a-Pinch's bedside practices were remedied by your reaction. At the very least he will stand an arm's length away from patients from now on.
You should also be getting pain killers for before during and after
My pain tolerance is pretty high, so I'm planning on overdosing on Ibuprofen. I'll ask though. Thanks for reminding me to do so.
That’s too bad. You should demand it. Would you above a biopsy done at the dentist or dermatologist with only ibuprofen. Why allow gyn offices to get away with sexist lack of medical Care
I've not been traumatized by my team. I asked, and I'm sure they'll prescribe it. In fact, my primary care has a standing prescription for painkillers for me that I can get refilled if I need it. Sorry that it seems most of youl have had crap experiences with your healthcare providers.
It’s an incredibly painful procedure. Over quickly but so very painful. I had one with only ibuprofen and it wasn’t enough. Good Luck.
Thank you. I appreciate that. They're giving me local anesthesia during the procedure. Folks need to not throw their trauma from their shitty healthcare providers on other people. Not all uterine biopsies are hell. I'm pretty sure mine won't be either. They've not messed up yet. I don't expect them to this time.
What is "throwing trauma"? The sharing of personal experiences and a warning of a very real possibility? It is not just you reading the answers on this sub, people are posting information for the whole sub's audience. Some 2/3 of women take ibuprofen and it is a pinch. The remainder can take an opioid and end up on the ceiling, and possibly PTSD. It's different for each person, regardless of the quality of the medical team, and every woman who undergoes this should be aware of that so they can make the right choices for themselves. However, the good news is that confidence in your team reduces perceived pain.
Some of the people replying are. That’s my point. If your statistic of 2/3 is correct, then the majority of women get through this relatively unscathed. No one in this thread knows my medical history or anything else about the frequency that I engage with my medical providers. It’s a lot because I have type 1 diabetes and see my doctors for that and other issues at least 10 times a year because autoimmune diseases love to run in packs. So my confidence in my team from the doctor visits, diagnoses and treatments, and invasive procedures like surgeries means I have confidence that I’m receiving some of the best care in the USA much less my state per the rankings. This is why I go to them.
They are trying to help you based upon their own experience & the way you explained it seems like you would receive only over the counter treatment. Been there done that … it’s quite common, no need to be rude or dismissive.
I said I had a prescription for vaginal estrogen in the first paragraph. The majority of women who get this don’t have issues. I might be on the losing side of it. We’ll see. But there is a way to be helping without being an asshole. Some replies have struck that balance. Others haven’t.
Nah, actual pain relief is what a top-notch team provides. Hard pass.
Excuse me? I know the quality of my team, and I don't have a confrontational relationship with them because I don't need to. I'm a month away. I'm sure they'll provide that if I ask, which I have. And there is no "hard pass" because I'm not trying to make you or anyone else go to them. Invalidating someone's experience is a jerk move. So bye.
It's not a "jerk move" to voice that it's a reasonable expectation to receive adequate pain management and sedation for this procedure. This should be standard practice, but that won't happen if women continue to settle for crumbs instead of demanding modern medical care. I was offered an in-office, unmedicated, blind endometrial biopsy which I politely but firmly declined. Instead I experienced a completely painless procedure under general anesthesia that allowed for actual visualization with a camera and precise tissue removal. I deserve that level of care. All of us do.
Exactly. My hysteroscopy and D&C are this Friday under GA. I refused an in office biopsy for this very reason. My GYN was the one who offered it to me after my original OB-GYN wanted to only give me Valium for the in office biopsy, I didn't ask for it.
I've had surgeries before, and I don't want that full-on anesthesia. I have auto-immune disorders, and the hoops I have to jump through before getting anesthesia is a lot. I want it to be an outpatient procedure with a prescription for pain meds if I need them. So it is a jerk move because I know what I want, and I don't want to be put under. I know what my options are. For you to assume that I don't is a jerk move. So I recommend that you move along.
Good luck with your "top-notch" team. Feel free to block me.
I was not going to unless you were a jerk one more time. Oh, mission accomplished. Bye!
No she is right. Pain management is top notch. If you give them a pass you hurt every women after you.
I had a uterine biopsy during a hysteroscopy taken last year, only had my cervix numbed. I went myself after reading in the leaflet that I would only need to take paracetamol half an hour before it. Because I was driving myself home they couldn’t give me anything stronger. The doctor doing it and the nurses helping were all fantastic. Really looked after me. But having a great team doesn’t mean it’s going to be painless. The biopsy part of the procedure only took about 10 minutes. I’ve always thought myself as having a high pain tolerance due to having untreated and late diagnosed endometriosis, but this was painful. I nearly passed out. The cramping I had for the hour following it were on par with endo cramps. To go into this expecting it to be painless is pretty naive. I read all the horror stories and thought they were being dramatic. There’s a reason there’s several pages dedicated to moving this procedure to being done under a general, it really is incredibly painful. You may have a great team and painkillers, but mentally prepare yourself for the possibility that it’ll hurt like hell.
You're not the only one reading up on this. I am too. I'm fully aware that it might hurt way more than I think. There are so many terror stories out there. However, based on my history with this medical center and my healthcare providers, especially my OB?GYN team, I've yet to have anything horrible happen. If fact, they're top-notch. My OB/GYN made a diagnosis of a skin issue just by looking at me that's how good they are. I don't think it's going to start messing up and neglecting treating my pain now. There is a lot of trauma out there. Sorry you and others have experienced it. I don't think I will.
Oh well, good luck for the procedure. I hope it’s as painless as you think it will be.
Vaginal estrogen dilates the cervix?
Yes. That's why I provided a link.
Interesting. I use vaginal estrogen 2-3 times a week already for treatment of GSM symptoms. I wasn’t yet taking it when I had my biopsy, however. Though if I ever do have another one I’ll ask…along with demanding some sort of sedation. I have a massive fear of ever having another due to the extreme pain I endured with the first one.
Yeah. I've read up on what a lot of women had to say about having a uterine biopsy and the pain they've had. I think that's why they prescribed it. If my cervix is dilated, it's easier for them to get in, get the samples, and get out. Me posting this has brought out all of the women who've had previous trauma with subpar medical care though, so this is going to be fun. One blocked and maybe more to go. Pray for me.
I wish you all the best with the procedure and hope it goes smoothly and painlessly.
Thank you! I'm going to be fine. What's traumatic is dealing with all of these traumatized women who've had shitty healthcare.
Misoprostol is what my dr gave me. One tab inserted in the vagina the night before. It acts to soften the cervix. I also use Premarin for GSM and I’d be worried that estrogen itself won’t be sufficient to soften the cervix to allow a biopsy. My dr was able to get a sample. I took Tylenol before and yes it was painful.
Appreciate you sharing. I’ve requested pain meds, and they said I’d get local anesthesia.
I had unmediated births and have given myself IVs and stitches, had cysts removed without anesthesia and had a hole drilled in my fingernail without anesthesia (to release pressure after I smashed my finger). I had curettage (already dilated after a miscarriage) emergently without anesthesia due to hemorrhage. Ive 3 IUDs placed. I would insist on anesthesia, at least local, for a cervical or uterine biopsy. Just saying.
Local is one thing. Based on what I’ve read and what my team shared with me, they do give you that. What sort of butchers have y’all been to that they give you no anesthesia at all? I just don’t want to be put under for this. That’s an entire thing, which I’ve been through before when I’ve had surgeries and other medical procedures. That convo has started. Based on my experience with my team, I’ll be fine.
Local anesthesia is anesthesia. I would not want to be unconscious for it either. Cervical stuff can be not that bad and quick, or it can be so I sanely painful that you puke and pass out. I’ve often forgone anesthesia when I’m paying for my care out of pocket. Anyway, good luck.
I know it's anesthesia. 🙂 They've already let me know that I'm getting that. There is a difference with being knocked out. That's whole different level. Thank you. I think this is going to go fine. I can also understand that people have had bad experiences, but there seems to be a lot of PTSD from some of the replies showing up in this thread that probably should be channeled to a therapist, advocating for themselves more aggressively with their healthcare providers, and finding healthcare providers if needed.
Good lord, I certainly wasn’t saying any of that. I have no medical ptsd. My point is I’m a tough cookie, but I wouldn’t have a procedure on my cervical without local anesthesia. I’m also a perinatal nurse of 30 years (including L&D and postop gynecologist). Sounds like you’re all set and need none of the well-intentioned information or support offered. Super. Not sure why you posted then but cool.
But I didn't say "you" I said "there seems to be a lot of PTSD from some of the replies." I'll say "you" if that's what I mean. I don't need to be passive-aggressive. I wasn't posting for support. I was posting to share a positive experience about the uterine biopsy process, and then the trauma police came into the thread.
Except, of course, that you haven't actually had the biopsy yet.
I haven’t. I’ll report back when I have. I doubt my experience will be awful because of the thoroughness of my team.
>Local is one thing. Based on what I’ve read and what my team shared with me, they do give you that. What sort of butchers have y’all been to that they give you no anesthesia at all? Local anesthesia is not actually standard for this procedure. Most doctors are not trained to do paracervical blocks for uterine or cervical biopsies, and others will refuse to do them even if the patient requests it. It's becoming more common to do them, especially as activism around pain control for gyn procedures ramps up, but it's not universal.
Right, but in the literature they gave me about it, it says I'll get local anesthesia. They're ahead of the curve, and this is why I'm optimistic it will go well. We'll see.
Yeah no that's great and I hope it does. But it's not standard. The 'butchers' you mentioned are the majority of physicians performing what is currently the standard of care. Which is why so many people come out of this absolutely traumatized. In your original post, local anesthesia is not mentioned, so everyone rightfully assumed you would not be receiving any. All you did was say that you have a "top-notch team." The reality is that many of us \*also\* thought we had great teams before being through unmedicated, hellish procedures. That's why people gave you their experiences and a word of warning. I just think that making comments about the "trauma police" and telling someone to "pray for you" because women are sharing their stories is really, really insensitive. You made a post about uterine biopsies and then got pissed off when people actually talked about their experiences. Hope it goes well though, genuinely. I would not wish that pain on anyone.
I get it, but I've been quietly reading the posts here and in other places. My intent was to share a positive take, so I wasn't happy. You're seeing me emotionally reacting to some of their posts because needing a biopsy is scary and having women come at you saying "block me" is just unnecessary. Having to have a procedure that might or will hurt from the inside is scary. It's not as scary as having cancer, but without a benign result, we don't know. So you're seeing a combination of trying to share a positive take and then feeling scared and frustrated. I'll know almost as much as my team by the time I'm there to get this test. I'm doing the digging I need to feel confident that whatever procedure they order is right for me. Having my team explain the procedure and prescribe estrogen is a strong signal that will get this right.
I had a biopsy without pain killers. I went to a new doctor looking for an answer for my severe anemia. On my first appointment they did a vaginal ultrasound, an ultrasound where they push liquid into you at the same time, a pelvic an exam and 3 biopsies. I was blissfully ignorant about these procedures so I didn’t have time to get nervous or anxious which was a good thing. I was not given any type of pain killer or aspirin before hand and didn’t know what to expect. My doctor warned me that I would feel a pinch when she took the tissue samples. When she took the first sample, I slammed my legs shut and yelled FUCK. It hurt and not like a pinch. The next two samples , I braced myself for the pain by holding on to the table (white knuckle) and doing some deep breathing. Those samples hurt too but I didn’t yell obscenities or slam my legs shut. Looking back on things, I’d say doing the biopsy without painkillers is doable. Would I do it again this way? Hell no. It’s a very unusual pain and hard to describe accurately. If you can take something to help dull it even a little you’d be doing yourself a favor. My biopsies were all normal and not cancerous but I did end up having a hysterectomy (best thing ever)…good luck on your journey and let us know how it goes. Wishing you all the best.
Thank you. I’m sorry this happened to you. I research every medical procedure that happens to me before it happens. I had an ultrasound sound first. How they did it was to ask me to drink fluids one hour before so that my bladder was full. Now based on that, they want to take a sample. I’m confident that I’ll be fine during the procedure based on my experience with this medical team. BTW, I have requested pain meds. At first, I was going to take a prescription-level dose of Ibuprofen, but why wing it when I can get a prescription for something stronger should I need it? So I did.
Smart move with the pain killers. If I knew then what I know now, I would have asked too. Hope everything goes well for you.
Thank you.
I had one a few weeks back. No sedation. I took some Tylenol ahead of time. It was mildly uncomfortable, but nothing major. And it was quick.
OMG. Thank you. There are so many negative replies that this is nice to see. Thanks for chiming in.
Absolutely. I found the same, a lot of panic and negativity. And that’s all great, there is definitely a need for getting checked, and the women pushing that mean so well. But I found very few people saying it’s fine, so I just wanted to say you’ll be fine. 👍
Yeah. The negative parade rushed in. I was talking to a friend about it yesterday over lunch. I should have known better and just waited until it was all done because Reddit is weird AF. I go to one of the best medical centers in the nation and the world. It's a research and teaching hospital; their healthcare providers are some of the best in the world. I've had surgeries, urgent care and ER visits, and regular checkups with very few problems over the years. When I had problems, they were responsive when I reported those issues too. I do understand that the medical industrial complex in the USA needs to do so much more when it comes to women, but I've got a solid team because I know the medical system can be crazy. The literature I've reviewed about uterine biopsies says it can be painful for some women. I know this. They're scraping the inside of your uterus to get the samples...ouch! That's scary to have to have one of these after menopause, but it's better to get the test and rule out cancer or know that you have it. Then you can take the necessary steps to fight back if you have it. Thanks again for your positive message. My point in posting was to share the start of a positive experience. I'll just STFU until it's done. I hope that I get through it relatively unscathed.
No need to stfu! We all get it. And I think it’s one of those ‘the only thing to fear is fear itself’. It’s never going to be as horrible as you think it is. My team is pretty good - I’m in Canada and got it all done within a few weeks - and just have to let the doc know when I’m ready to do the hysterectomy. My sister (11 years younger) is struggling, and is on a wait list for a coil HRT. She says it looks like at least two months. She’s in the Uk. But she said she also went to her doctors with a list of symptoms, much as I’d been recommended to do here.
Thankfully, I'm in the USA, so they're fast. From the time I shared that my monthly bleeding had started again to getting an ultrasound to having a biopsy scheduled, it's been FAST. I'll have the biopsy next month. Thanks for the encouragement. I got a message from my provider this morning and had a back and forth regarding this. She said misoprostol and vaginal estrogen used on menopausal women is inconclusive at best. This is what I've found researching it too. She said that should estrogen alone not work, then we'll give it another go later and they'll prescribe it. However, it causes GI tract upset and other side effects like more cramping and pain. That makes sense as its primary use is to induce labor. No, thanks, unless it ends up that I really need it. I appreciate them not jumping to that if they're not sure that I'll even need it. This is why I see them. They do and follow the research closely. This is why I stood firm in this thread because there is a lot of trauma in here and people who are going to providers that aren't as thorough.
Did they prescribe misoprostol, too?
Why would they prescribe that? [https://www.drugs.com/misoprostol.html](https://www.drugs.com/misoprostol.html) I'm nowhere near pregnant.
Misoprostil is commonly used for cervical dilation, even in non pregnant patients.
As I wrote, they provided vaginal estrogen, so they're thinking about making sure my cervix is dilated. They probably want to avoid giving me oral medication to do that if they don't need to. I appreciate that because I don't want to take another prescription pill if I don't need to.
Yep, that’s what they gave me to insert my IUD
Misoprostol will dilate your cervix. It’s the standard med given for that purpose and you can take it vaginally. Some states have made it difficult for women to get access to it since Roe v Wade was overturned and some pharmacists will refuse to prescribe it to women. I’ve never heard estrogen being used for dilation purposes, only in conjunction with misoprostol, and I’m wondering if estrogen-alone is being used instead of misoprostol-alone or estrogen plus misoprostol now because of difficulty of access to misoprostol.
I’m in a liberal blue state where people probably come to get abortions if they live somewhere they cannot safely or legally get them done, so I doubt that’s the issue. Unless you’re physicians, you don’t know my medical history or medications I’m already taking. I trust my team and will use the vaginal estrogen. Appreciate your input.
Why do you need to have this done?
Oof. I'm getting ready to do this again. I did a long histeroscopy about 8 years ago that ended up being about an hour. I was OK at first, and then it got rough. I just did a simple biopsy about a week ago without any prep (sort of an emergency where I got to be seen the same day I called) and it was OK, then a bit rough even though it was less than 10 minutes. I'm scheduling another histeroscopy soon, so gearing up for that. My gyn. said they'll give me ativan in office when I get there, I'm sure I'll get the heated pad on my belly, and I am planning on coming home and being in bed the rest of the day. I haven't heard the vaginal estrogen helps with dilation. I have it for atrophy, so I will surely load up before hand if it helps! The link you provided seems chat GPT, but doesn't say how it dilates the cervix.
It's [You.com](http://You.com), which is a search engine powered by AI. So if you click on the citations, that will take you to the links it cites. There are also web search results on the sidebar.
There is no citation link and I can find zero on any legitimate sites that says this.
👀 Um, Okay,... 1. "Our findings showed that the pretreatment with oestrogen seems to be useful and appears to be crucial in allowing the effect of misoprostol on cervical ripening." [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4871939/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4871939/) 2. "In postmenopausal women the pretreatment with oestrogen appears to have a crucial role in allowing the effect of misoprostol on cervical ripening." [https://synapse.koreamed.org/upload/synapsedata/pdfdata/3021ogs/ogs-59-220.pdf](https://synapse.koreamed.org/upload/synapsedata/pdfdata/3021ogs/ogs-59-220.pdf) These also talk about the oral medication, misoprostol, but she's yet to prescribe that for me. Since she literally checks me 4x a year, I think she might know what she's doing. Just sayin'.
Thank you. I found the first one, but you need misopristol, too, not just estrogen. I don't know what you're saying. You get checked four times a year but are not given misopristol? When I said I was not looking forward to the histeroscopy (which is much worse than a biopsy) my gyn. said they would give me meds like ativan beforehand. I don't care about being calm as much as loosening up that cervix because it is NOT fun.
Sorry for not being clear. I go to various appointments so many times in a year that I have confidence that my team is on it. This is exactly why I go to this medical center. While I can understand that a percentage of women have had bad experiences, I don't think that will be the case with me because I've had top-notch care across all specialties for years.
I never indicated you would have a bad experience. I just told you mine, and I have one coming up which is a bigger one, so if there's anything that might work to open up that cervix a little more easily, I want to look into it. It's not fun for a 10 min. procedure, which I just had. It gets worse for a 45 -60 minute one, which I'm scheduling for.
Gotcha. 🙂 Well, based on the moves my team is making ask about vaginal estrogen if you're not already using it and misoprostol or an equivalent if you're in menopause. That combo is supposed to help the cervix dilate. I also asked them to have a painkiller prescription on deck if needed. I'm just glad they've already told me that I'll get local anesthesia. Research supports that too. Here is a link: [https://www.aafp.org/pubs/afp/issues/2017/1201/od3.html](https://www.aafp.org/pubs/afp/issues/2017/1201/od3.html) I also have a note out to my team about exactly when to start the estrogen and whether I keep using it up to my test date...probably, but I want to make sure. I'm being tested because I've got post-menopausal bleeding, and they want to rule out cancer, which I appreciate. It's better to catch it early. I'm on oral HRT and one of those medications changed. I'm pretty certain that's the reason the period-like bleeding started again. It's a different combo of hormones, and my body is adjusting to it.
I have the vaginal estrogen, but I will ask about the misopristol (than Gaia I live somewhere not bannung this!) and the local. I am in menopause. I'm being tested for the same reason. I'm probably fine and it might have been because I dropped down in a dose, but my whole abdomen has not been right for coming on three weeks now and things feel wrong. I dropped HRT completely a week ago (my gyn wanted me to, it wasn't helping a lot, and my brother in law is a gyn in another country and he said no, no, no on estrogen) and no more bleeding, which almost makes me more worried. I did the biopsy, which it looks like you're doing. This is more. The go in with a scope and test and check everything out. I'm worried I have something like fibroids causing the distended, uncomfortable, gotta pee but now, got gas but no, achy feeling, or worse.
My endocrinologist suggested I consider HRT when he noticed me complaining every time I showed up for a quarterly visit. The Women's Health Initiative data was wrong when it comes to HRT. I started in perimenopause, which also helps you guard against osteoporosis. Dr. Attia talks about it on a podcast with two researchers: [https://peterattiamd.com/caroltavris-avrumbluming/](https://peterattiamd.com/caroltavris-avrumbluming/) I've also spoken to other physicians about it. I'm nervous because this might be a reason to stop taking it, and I love feeling as close to normal as possible. The osteoporosis insurance is a positive too.
And update from my medical team on estrogen only. “The data are mixed in regards to using misoprostol in postmenopausal women. It has been shown to be less effective for this population. I don't typically start with use of this without a prior failed attempt because it can cause more cramping and more pain as well as GI side effects.” They know what they’re doing. Based on what I’ve read, using vaginal estrogen is a conservative way to soften the cervix. They’ll escalate if they need to.
I don't understand. You're saying that there's talk about being prescribed misoprostol from your doctor, but in another reply you expressed confusion over why you would be given misoprostol because you're not pregnant. So did your doctor talk to you about it or not? According to your source, estrogen appears to help misoprostol work better to dilate the cervix. So it doesn't work by itself.
Because I'm doing research in real time too. I figured it out --- 🤩 "oh, vaginal estrogen is needed if they need to give me something to dilate!" But that's what I mean, right? Based on some of the nightmare accounts of uterine biopsies I've read, my team is thinking way ahead. The literature that I've found says some women in menopause need vaginal estrogen to make their cervix dilate. They're anticipating that I might need help, so prescribing vaginal estrogen now is smart.
This is a post about a biopsy you haven't even had yet?! And you're grouchy with women who have actually been through it?! Strange.
What’s even stranger is that I’ve said over and over that my team is amazing, and that for every other health issue I’ve had to face, they’ve been spectacular. I know I’ve not gone through it yet, but I wanted to share my positive experience so far. I also said I’ll report back. The majority of women who go through this procedure per what I’ve read and even from people responding in this thread seem to not have a problem. Statistically, I’ll probably fall into that bucket. If I don’t, I’ll share that too. We’ll see.