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

Posted by suesam @suesam, Dec 21, 2024

Hi there, I have no bleeding but my endometrial thickness is a 6 and I have an endometrial biopsy scheduled in 30 days and I'm terrified. I made the mistake of reading all the horror stories on the internet. My doctor said it is painful and is preparing me by asking me to take VagiFem 10 for the next month and also to take advil before arriving. I've had pap smears all my life and they never hurt but my last one did. But I think that's because the doctor ( mine retired ) used a large instrument which hurt but then switched to a smaller one which was fine. It's a different doctor who will do the biopsy. I've had 2 transvaginal ultrasounds which didn't hurt and one hysterscopy which didn't hurt at all. But I'm terrified of the biopsy. My ultrasound showed a thickness of 6, nothing else, and my CT scan showed nothing. I wish my doctor hadn't told me it would hurt - when I said my last pap smear hurt, he said this would hurt more. He wasn't trying to be mean, just preparing me. I'm hoping I can do it. Any thoughts? And thanks for listening.

Interested in more discussions like this? Go to the Gynecologic Cancers Support Group.

Profile picture for carol1024 @carol1024

It is carcinosarcoma a very aggressive and rare endometrial cancer. My survival rate is 0-10% if in advanced stages. It is in lymph nodes in pelvic area. I'm having a pet scan March 12th. I'm getting port Wednesday the 5th. I'll have 3-5 hour treatments of chemo when emergency authorization comes through. Hoping for chemo the same week I get port but may be following Monday. If, after the first 3 treatments there's no shrinkage of lymph nodes, so they can see where surgery needed, then I will transfer my care to a local female oncologist and give her a try. I have nothing to lose because they won't do surgery if chemo isn't successful. Needless to say, I am terrified.

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carol1024, I wish you the absolte best. I want you to know that my mom, in her sixties at the time, was dx'd with carcinosarcoma in 2013. She had a hysterectomy and local radiation, and went on recurrence free till 2021. In 2021 it appeared in her lung (it has predilection for that), she had surgery and a few rounds of chemo- she is still alive and kicking in 2025. Hang in there and all the best to you.

PS- I am dealing with my own unfortunate issues, undergoing a uterine biopsy for heavy midcycle bleeding, but that's a whole other story... Prayers up and soldiering on. I might be back on here for support at some point myself.

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Profile picture for gmasuzy @gmasuzy

My Dr. had ordered a biopsy because I was having post menopausal bleeding and cramping. Because I was already in pain I asked to have it done under local anethesia, I was referred to a Surgeon that agreed to do it. I had 4 previous ultrasounds that did not detect the large tumor that was in my cervix so I’m glad that I didn’t agree to having it done in a drs office with just a zanax for the pain. Everyone is different though and my circumstances were not common but as my Dr found out biopsy’s are not a one size fits all. You are the only one that knows how much pain you can tolerate., and I think alittle more consideration needs to be given to anyone that had to go through something like this . And perhaps given the choice to have something alittle stronger than a low dose pain reliever

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I agree with you 💯

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Profile picture for gmasuzy @gmasuzy

My Dr. had ordered a biopsy because I was having post menopausal bleeding and cramping. Because I was already in pain I asked to have it done under local anethesia, I was referred to a Surgeon that agreed to do it. I had 4 previous ultrasounds that did not detect the large tumor that was in my cervix so I’m glad that I didn’t agree to having it done in a drs office with just a zanax for the pain. Everyone is different though and my circumstances were not common but as my Dr found out biopsy’s are not a one size fits all. You are the only one that knows how much pain you can tolerate., and I think alittle more consideration needs to be given to anyone that had to go through something like this . And perhaps given the choice to have something alittle stronger than a low dose pain reliever

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@gmasuzy Welcome to Mayo Clinic Connect and especially to our Support Group. Thank you for sharing how you advocated for yourself and reminding us that we are all different even through our circumstances may be similar.

Would you like to share a little more about yourself? What happened after the cervical tumor was found? Did you have surgery? A hysterectomy? And how are you feeling in your life now?

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Profile picture for gmasuzy @gmasuzy

My Dr. had ordered a biopsy because I was having post menopausal bleeding and cramping. Because I was already in pain I asked to have it done under local anethesia, I was referred to a Surgeon that agreed to do it. I had 4 previous ultrasounds that did not detect the large tumor that was in my cervix so I’m glad that I didn’t agree to having it done in a drs office with just a zanax for the pain. Everyone is different though and my circumstances were not common but as my Dr found out biopsy’s are not a one size fits all. You are the only one that knows how much pain you can tolerate., and I think alittle more consideration needs to be given to anyone that had to go through something like this . And perhaps given the choice to have something alittle stronger than a low dose pain reliever

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Good points here! Especially about advocating for oneself and asking for what we need. So you had a large tumor in your cervix? Did you end up with a hysterectomy? Hope you are doing okay, now.

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Profile picture for topsz @topsz

Well. I have had three. And yes they do hurt. I don’t know why drs don’t give anything stronger for pain for the procedure. Fortunately the procedure doesn’t last too long and once it’s over you will be fine. Hope your results are negative.

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My Dr. had ordered a biopsy because I was having post menopausal bleeding and cramping. Because I was already in pain I asked to have it done under local anethesia, I was referred to a Surgeon that agreed to do it. I had 4 previous ultrasounds that did not detect the large tumor that was in my cervix so I’m glad that I didn’t agree to having it done in a drs office with just a zanax for the pain. Everyone is different though and my circumstances were not common but as my Dr found out biopsy’s are not a one size fits all. You are the only one that knows how much pain you can tolerate., and I think alittle more consideration needs to be given to anyone that had to go through something like this . And perhaps given the choice to have something alittle stronger than a low dose pain reliever

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Profile picture for acorvettemom @acorvettemom

Hi, I did have bleeding and my thickness was a 10 after the transvaginal ultrasound. They wanted to do the same biopsy, but I told them absolutely not and they were going to have to knock me out. My doctor agreed to do a D&C. Which in my particular situation was good because they found the endrometrioid carcenoma 1-1/2 weeks ago. I have to have a hysterectomy but don't know anything other than the cancer is the common kind. My 1st Oncologist appt is in 5 days. (see if your doctor will give you the option of a D&C if you're able).

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@acorvettemom Well done advocating for yourself and having a D&C instead of the endometrial biopsy without sedation. Like you, I got the diagnosis of endometroid adenocarcinoma after the D & C. It was a huge shock to get that diagnosis. I asked for a referral to Mayo Clinic since my rural area does not have anyone who specializes in gynecological cancers. I got in to Mayo Clinic within a few days after diagnosis and had the hysterectomy the following week.

Your oncology appointment is coming up soon. I'd suggest writing your questions down before your appointment and taking someone with you. In retrospect I'm relieved that I did both of those because I was anxious and frightened when I went to the appointment with the GYNOncologist for that first time.

Do you have any other suggestions for our members?

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Profile picture for acorvettemom @acorvettemom

Hi, I did have bleeding and my thickness was a 10 after the transvaginal ultrasound. They wanted to do the same biopsy, but I told them absolutely not and they were going to have to knock me out. My doctor agreed to do a D&C. Which in my particular situation was good because they found the endrometrioid carcenoma 1-1/2 weeks ago. I have to have a hysterectomy but don't know anything other than the cancer is the common kind. My 1st Oncologist appt is in 5 days. (see if your doctor will give you the option of a D&C if you're able).

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This is good to know - to advocate for being knocked out. So sorry to hear about your carcinoma. You must be terrified. Wishing you all the best at your oncologist appointment coming up. I'm still waiting for my biopsy results. I'm glad you shared, it really helps me knowing all sorts of alternatives. But I am sorry your results show carcinoma.

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Profile picture for grandefish8 @grandefish8

Doctors DO prescribe more than an Advil for a endometrial biopsy. I just had my biopsy in February. Ahead of time, I did my research on Reddit to learn about women's experiences and what pain management was used for their procedure. I also advocated for myself by requesting and having a pain-management phone call with the doctor's nurse. I told them I was terrified, emailed them a study that showed the most effective pain management strategies, and also told them I'd had very good results on a painful knee surgery with hydromorphone — and that I'd prefer hydromorphone to Norco, which was initially offered.

Ultimately, I was prescribed: an 800mg Motrin; 1-2 Valium (5mg each) and a hydromorphone (can't recall dosage). I took them all about 25-35 minutes before the biopsy. My gynecologist also used lidocaine (I believe it was sprayed and/or injected into my cervix - not sure). I also had a nurse holding my hand, and we talked about one of my favorite topics -- dogs -- during the procedure to distract me. I was pretty high due to the meds, honestly. The biopsy "pain" actually felt like a little twinge, like if someone pinched your tummy. Not at all painful or traumatic. I hope this helps!

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Hey, thanks for sharing this. Good to know. I did have the freezing done and took advil but it's great to know about other alternatives. Have you got your results yet? My biopsy was 2 weeks ago and I was told it could take 8 weeks.

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Hi, I did have bleeding and my thickness was a 10 after the transvaginal ultrasound. They wanted to do the same biopsy, but I told them absolutely not and they were going to have to knock me out. My doctor agreed to do a D&C. Which in my particular situation was good because they found the endrometrioid carcenoma 1-1/2 weeks ago. I have to have a hysterectomy but don't know anything other than the cancer is the common kind. My 1st Oncologist appt is in 5 days. (see if your doctor will give you the option of a D&C if you're able).

REPLY

Doctors DO prescribe more than an Advil for a endometrial biopsy. I just had my biopsy in February. Ahead of time, I did my research on Reddit to learn about women's experiences and what pain management was used for their procedure. I also advocated for myself by requesting and having a pain-management phone call with the doctor's nurse. I told them I was terrified, emailed them a study that showed the most effective pain management strategies, and also told them I'd had very good results on a painful knee surgery with hydromorphone — and that I'd prefer hydromorphone to Norco, which was initially offered.

Ultimately, I was prescribed: an 800mg Motrin; 1-2 Valium (5mg each) and a hydromorphone (can't recall dosage). I took them all about 25-35 minutes before the biopsy. My gynecologist also used lidocaine (I believe it was sprayed and/or injected into my cervix - not sure). I also had a nurse holding my hand, and we talked about one of my favorite topics -- dogs -- during the procedure to distract me. I was pretty high due to the meds, honestly. The biopsy "pain" actually felt like a little twinge, like if someone pinched your tummy. Not at all painful or traumatic. I hope this helps!

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