Endometrial Biopsy: I’m terrified, what can I expect?

Wow, Helen, you are amazing. Yes, all your suggestions speak to me.

You're right, my anxiety and worry is pretty darn normal in these circumstances. I need to accept it. Having a biopsy is pretty scary.

I think it's a good idea for me to write out my worries. I am aware that it can be cancer, but also other things too. As my doctor says, 'It could be just the way I am.' I am also grateful my doctor is taking it seriously. He's a pretty great guy.

I live in Canada, so I don't need insurance for this test - so I am very grateful for this, that's for sure.

Thank you for taking the time to encourage me. I wish you all the best, too.

@suesam I understand the anxiety associated with that biopsy. I have been in similar situations with tests looming in the distance. I'm going to suggest what I do. It doesn't remove the worries that accompany anxiety but it can be calming in the moment.

1. I remind myself that my worries are normal under the circumstances. Do I like anxiety? No, not all. Can I accept the anxiety? Yes, that's what I tell myself. My anxiety is present for a reason. It got my attention and so now it's time to let it go at least momentarily until it arises again - and it does. The more I do this skill of reminding myself that my anxiety is normal under the circumstances the more "normal" I feel.

2. I write my worries into a notebook to "get them out there". I figure out which of these worries are rational under the circumstances and which might be irrational (catastrophic thinking). An example would be writing a worry that the biopsy will show I have cancer. That's the worst case scenario and is an example of catastrophic thinking. I can't possibly know that. What I can know is that the endometrial biopsy may show nothing or it may show something. What are the reasonable possibilities?

3. I write what I am grateful for. In this case it could be that I am grateful I have a doctor who is taking me seriously and is following up. I am grateful that I have the resources (insurance) to see a doctor for this test.

Do any of the suggestions I have made speak to you?

Hi there, I am the same. Scheduled for a biopsy Jan.23. Sounds like you are in good hands with your doctor.

Hello there,
I still find it hard to concentrate with this biopsy hanging over my head. It's not until Jan 20 and I keep trying to push it out of my mind. Guess I'm still in shock and I'm trying not let my mind run away and live in the present moment. My CT scan and Ultrasound showed nothing, except the ultrasound showed a thickness of 6. I was actually happy because my last one 6 months ago was a 7. I have no visible bleeding at all. I was sure my doctor was going to say, "Let's test again in 6 more months.' Anyhow, it set me off on a path of worrying, but I'm trying to not let it get to me. I am grateful that he's checking but scared. Thanks for listening.

Hello there,
I still find it hard to concentrate with this biopsy hanging over my head. It's not until Jan 20 and I keep trying to push it out of my mind. Guess I'm still in shock and I'm trying not let my mind run away and live in the present moment. My CT scan and Ultrasound showed nothing, except the ultrasound showed a thickness of 6. I was actually happy because my last one 6 months ago was a 7. I have no visible bleeding at all. I was sure my doctor was going to say, "Let's test again in 6 more months.' Anyhow, it set me off on a path of worrying, but I'm trying to not let it get to me. I am grateful that he's checking but scared. Thanks for listening.

Good morning, @suesam

It already sounds as if you've "got" this. Good for you for reaching out for support! I'm sharing about my experience and what helped in case any of it might help you feel less afraid or more ready to cope.

I had an endometrial biopsy in 12/21 when I sought care for very light post-menopausal bleeding. I had no other symptoms, but knew this was something to ask about. My PCP sent me straight to an OB/GYN because of GYN cancer history in my immediate family.

I was a bit nervous about whether the (likely) procedure would be painful, so asked a sister for her advice, and she told me to take plenty of ibuprofen an hour before the visit. Well, I forgot to do that until I was in the exam room (and the whole thing was over before I'd even digested the capsule). A transvaginal ultrasound at the same appointment showed a 7mm thickness of the endometrial lining. The biopsy was what I would call "fairly uncomfortable" and was over in 5-10 minutes. The clamp on my cervix was uncomfortable (3-4/10), the insertion of the tube was slightly uncomfortable (1-2/10) and the 3 scrapes of the inside of my uterus made me want to squirm (4-6/10). I used long, slow out-breaths to get through that. Again, it was over quickly. I had a tiny bit of spotting after, and very, very mild cramping during a long drive home over mountains (this was the only available GYN I could locate during the pandemic and was on the other side of the state). My biggest complaint was that my husband (who had come along for support) and the GYN kept up a steady stream of conversation (thanks, dh) throughout, so I was sort of alone in managing those moments. Needless to say, we both learned a lot during that visit regarding what I need for support.

I am being very specific about the experience. I do not believe that I had any analgesia on board during the entire procedure. If I had to do it again without pain relief, I would. The information (at the time) that there was no cancer was a huge relief. It was not until a year later that I had a second experience of bleeding, after which a hysteroscopy revealed endometrial adenocarcinoma, State 1a, FIGO 1.

As you have written, the value of an earliest possible diagnosis, if there is cancer, is huge.
I like that your PCP has given you the vaginal inserts, which should make the exam much more comfortable, as your tissue will be more pliable and moist for insertion of the speculum.

I DO agree with you taking some kind of NSAID ahead of time. If you take it 1/2 hour prior to your appointment, you should be well-within the window of its maximum effectiveness when the procedure takes place.

Other, non-medicinal strategies that have helped me with pain:

-A hand to hold or squeeze would be nice.

-Asking ahead of time for quiet (or music).

-Telling the doctor what I might do to manage discomfort so they recognize that I'm in pain if I do those things.

-Long, slow outbreaths were my best friend in those moments.

-I could tell myself, "This is a moment. It will be over soon. I think I can tolerate this for a while longer."

-Another strategy that has helped me with pain is to mindfully scan my body to locate a part that is NOT experiencing pain. This could be an earlobe, a toe, a finger tip, or whatever you find. Then I shift my attention back and forth between the location of any pain and the location without pain, focusing on how my body tells me that it is not in pain...relaxed, soft to touch, cool/warm to touch, how much easier it is to breathe when I focus on that non-painful part, etc. I can go back and forth as needed. Noticing the pain and then shifting my attention away from it reduces my experience of pain.

-I can sing in my head or out loud, pray, or give my thinking brain a job that keeps it busy.

-Counting the length of my in-breaths and out-breaths helps me to focus there instead of on the painful part.

I will be keeping you in my thoughts, @suesam, hoping you get through this with a minimum of discomfort and receive good news as a result of your courage and tolerance. We're all here whatever unfolds.

I had no gyne symptoms whatsoever, but urologist recommended a vaginal and pelvic ultrasound and found that my endometrial lining was 14. Then, went on to do a PAP, which was positive. D&C was scheduled right away to do the various biopsies. The gyne recommended general sedation because it is painful and the procedure would be longer than a typical biopsy of the uterus. I did not have any significant pain afterwards except for some soreness in the abdomen and spotting for about 6 days.

Perhaps you could ask for a paracervical block? I did, and other than the little pinch of the needle from the block.I felt no pain.