I need a gynae biopsy - "Take some painkillers before you come"

[CantFindTheBeat]

Hi all,

Not sure if I'm wrong to be a bit annoyed about this. I'm way past menopause and recently had some bleeding. GP took it seriously, sent for a scan, internal scan done, sonographer was fab, all great in terms of speed and service.

I've just received a call from a different unit to book in for a biopsy. Great again in terms of speed and process. I'm not that worried as sonographer was very reassuring, but I'm really pleased they are being thorough.

The person on the phone who called me to book said 'please ensure you take some pain killers before you come'. I said why is that? She said because it can be a painful procedure - you will have a local anaesthetic but it will be painful - i know, the things us women have to put up with!"

She was really pleasant and sympathetic, and it is the system, not her, of course. but I'm really apprehensive about the appointment. I have a very low tolerance for pain anyway unfortunately, and think this could be hideous.

I am so pleased that I am being investigated, but am I right to think that men would not be expected to have internal cells taken for a biopsy without proper anaesthetic and it's another thing women are expected to put up with?

Or am I wrong, and this is par for the course for everyone?

(and what painkillers should I take before the appointment?)

Actually, now I remember, I was given gas & air for my hysteroscopy.

Didn't work, though.....but I hated using it during childbirth as well. Just made me feel sick and dizzy.

I don't know if it is urgent - I've had a scan which the sonographer was happy with - I hadn't expected to be recalled, but I'm happy that they are thorough.

I agree with you about labour, Ciderlout - epidurals should be readily available. I didn't have one with either of my two - not because I didn't ask, but because like you, there wasn't anyone to do it.

I did have pethidine and gas and air though - surely a sedative could be given in the instance of a biopsy - it's not only a scale of local anaesthetic or general, is it?

Thank you, @TheSoundThatIWasHearing - I'm going to - thank you and I'm sorry you had to go through that.

Very true. What about gas and air? That might make you more relaxed and they can’t possibly refuse you that?

I had a biopsy done too OP, a few years ago now.

I was offered a choice, and I did not go with the GA. For various reasons, but mainly I am high risk for GA so will do anything to avoid one if possible. And it does take me longer to recover from a GA than the actual procedure usually. And I have to pay for it essentially, so there is the cost to factor in.

I am trying to remember what I took pain relief wise, and I am pretty sure it was codeine/ paracetamol mix.

But it really was not as bad as I expected it to be. The worst of it was waiting for the results.

@CantFindTheBeat I had to have similar; was told it would feel like a "very strong pinch" and to take pain reliever prior to appt in gynae's office. It still wasn't pleasant.

That sounds like a hysteroscopy and biopsy which can hurt like hell - Google Hysteroscopy action group and don’t feel pressured to have a local if you don’t want one and can medically have a GA.

I had one with a biopsy a while back under GA - I was offered nothing, everything in-between, and a GA. I took the GA and don’t regret it for a second. I was in and out in no time, and back on the ward having tea and a sandwich. All NHS. I was surprised at the amount of bleeding - it was a full on period, and deemed perfectly normal when I was checked. Just be aware that you might have similar.

But she said you get a local. I've had it and it was absolutely fine; like getting a tiny needle anywhere else.

And no they wouldn't knock a guy out for a minor biopsy elsewhere on his body.

Quite apart from it being obviously barbaric to expect women to wait and see if it might cause them unendurable pain or just severe pain. It’s surely a complete waste of time for the nhs to be stopping proceedings mid way to rebook another with proper aesthetic?

Id tell them you’re entitled to proper pain relief so that’s what they need to provide.

I had one recently and it was torture. What's worse, the consultant made me feel like I was making a fuss about nothing - and I've delivered 2 children vaginally. Apparently it's worse post-menopause.

This article reflects my experience and it's an absolute scandal. Another example of women's health and wellbeing not taken seriously:

https://www.bigissue.com/news/social-justice/women-severe-pain-hysteroscopy-nhs/

I’ve had three and am about to have my fourth. First one was fine, quick, no pain relief at all. Second took over an hour as she had difficulty getting into my cervix. I was crying with pain. No pain relief offered. Didn’t insert the Mirena due to “my distress.” Told me it was my fault that she had difficulty getting in as I’m fat, and my being fat was why I’d also had melanoma. Third time, insisted on local anaesthetic. No problem at all, and she managed to get the coil in too. Told had to use a longer speculum as my cervix was high. Not to do with my being overweight. Fuck knows what this week’s will bring. Good luck.

I had a hysteroscopy, biopsy, polyp removal and Mirena coil insertion in February. I was advised to take two paracetamol beforehand, which I did.

Honestly, cross my heart, it was completely painless. I know many women find it agonisingly painful but I hardly felt a thing.

My gynaecologist reckoned I'd be fine as I've had three natural births but said I could opt for GA if I wanted it. He was right, in my case.

It seems like it's a real lottery whether women are going to be OK without a GA or not. I was lucky.

I had a hysteroscopy and it was tremendously painful, and I suffered from PTSD afterwards.
Statistically, roughly a third of patients have mild pain or discomfort, a third have moderate pain and a third suffer severe pain but you just don't know in advance how it's going to be for you. I had given birth twice without pain relief, never had a problem with painful periods or smears so thought I'd be OK, but how wrong was I? When they compare it to period pain they are lying.
If I had to have one again, I would personally request conscious sedation, which is offered for colonoscopies and gastroscopies, but is very rarely suggested as an option by medics, although it's not contraindicated.
My suspicion is that as it's cheapest to give women awake outpatient treatment and let them suffer that's the NHS's preferred option, but GA is grudgingly offered as they are obliged to, and they hope the risks will put patients off it. Conscious sedation is less risky than GA but rarely used by the NHS for no valid reason. It's scandalous and has been raised in the House of Commons multiple times, but still it goes on.
OP - you can get support and info from the Campaign Against Painful Hysteroscopy about this. Best of luck.

Thank you for sharing, @Mumtobabyhavoc xx

That's the sort of thing that makes me thing "how on earth can they say that?" "it will feel like someone reaching inside your womb and giving it a really hard pinch".

I mean, that sounds awful!

I had a biopsy a few months ago, took painkillers beforehand as they suggested and it was fine, painful briefly but fine. But then I read a thread here and many found it far more painful. I don't know how anyone can predict which way they react so I hope you have my experience rather than one like some people who really suffer.

I had exactly the same procedure on Friday (for the same reasons by the sounds of things).

Took paracetamol and ibuprofen before I went and was fine. It was uncomfortable and it aches rather than a pain. They said if it got too uncomfortable they would give me a local anaesthetic, but it wasn't needed. They couldn't find the entry to my womb, so had to poke a hole through my cervix (lovely), so I've had some minor period pains since the procedure, which they explained might happen. The whole thing took less than 15 minutes.

I understand you're apprehensive that's normal but it wasn't as awful as I thought it would be. Just very undignified and not a pleasant experience, but it was no worse than having my teeth cleaned at the dentist - just without my fanny stuck in the air

That is truly terrifying, @Hysteroscopyhell. I'm so, so sorry you had to go through that.

I'm definitely not going ahead without better anaesthetic. I have tried to speak to the hospital today - got put through to the department after being on hold for 20 mins, then automated 'mailbox full'.

If I need to, I'll head over to the appoint and speak face to face. It's on Sunday which I guess shows how busy they are, but I'm not going ahead if I'm not happy with their approach to the process.

Agonising hysteroscopy www.mumsnet.com/Talk/womens_health/5067904-agonising-hysteroscopy
Have a read of this similar recent thread.
Having this procedure done was extremely painful for me, and never again will I let them do it without a GA.

I'm so sorry that you had to go through that, @Aydel that's horrific treatment.

Thank you so much, @BigGapMum I'm so sorry that happened to you. Thank you for sharing and for your advice.

I refused to have mine done unless it was under GA. My cervix and uterus do not like people going in there and I once had a hysteroscopy and got up off the table and went home as it was so painful. I had a polyp removed and biopsy done last year under the GA.

You are right, this wouldn't happen to men.

I have requested a GA for a hysteroscopy because I haven't had children and I have a tilted cervix. I really don't want to go through a barbaric procedure without anaesthetic. I find smears unbearable.

I'm having a colonoscopy on Thursday and for that sedation is offered as routine. Why is that when they are similar procedures.

The misogyny in the health service is terrible. Women are just expected to put up with pain and many posters on this thread seem to agree. Women are seen as making a fuss if they ask for adequate pain relief.

I have had a san and biopsy done once a year for the last 6/7 years all were fine uncomfortable but ok the last one was really painful the consultant asked if I had had a general for my last procedure er no as I didn't need one. I have never been asked to take any pain relief on the day.

I really think it depends on who is doing it, sorry that doesn't help you at all.

What nonsense. My dad had a neck biopsy last week without any anaesthetic, local or otherwise.

You have control here and it's something which they're required to do within 2 weeks, so don't let them fob you off. Maybe print off that article and the similar BBC one (search online for hysteroscopy & BBC).

There are risks to a GA as well but YOU should be the one to make a decision based on informed consent.