Endometrial biopsy vs hysteroscopy

[Serendipity09]

Please no scary stories!!
I have recently had an endometrial biopsy and TV ultrasound scan as tests for heavy periods. Have recently had chemotherapy for breast cancer so I really think it is something to do with that - so much for the chemo putting into the menopause!
Anyway, the biopsy came back clear, but the scan has shown endometrial thickening of 14mm and cystic spaces with no vasculature. The gynae thinks it could be polyps.

So tomorrow I have a hysteroscopy. I went for it 4 weeks ago but it was cancelled as I had got so worked up from all the horror stories that my BP and pulse were through the roof!
So, my question is, has anyone had an endometrial biopsy and then a hysteroscopy? If so, was it majorly, majorly worse? The consultant said to me when I asked her 'oh, it is very different, it causes pain'. Thanks for that!
Please don't give me any more scary stories, but has anyone found it to be bearable? I need to keep my BP down!
I didn't find the endometrial biopsy painful at all, have had breast biopsies with little pain, wire put into breast lump under ultrasound with little pain, radioactive injection into breast etc, and 3 months of chemo, all fine. But I'm terrified about this!

Ive had this with local anaesthetic and it was fine, the consultant kept trying without anything for a while and I think as I haven't had children it was harder. But as soon as he did the local it was ok. Next time I will ask for local straight away and on a scale of 1 - 10 I would say its a 3/4 pain and discomfort wise.

im also going to take a couple of pain killers, but check with your GP first as im no one has ever advised this ive only read it on here.

I've had a hysteroscopy with no anaesthetics at all. They took a biopsy. No problems at all, not painful. Just a bit uncomfortable but it was over very quickly.
It was for heavy bleeding too and a thickened uterus but all came back fine.

I had a hysteroscopy with a biopsy taken at the same time and can't see that there's much difference. In both situations the speculum holds the vagina open like when doing a smear test, then something thin is passed through the cervix to the uterus. In the case of a hysteroscopy it's a thin telescope with a camera and light on the end so the womb can be examined. They have improved a lot over the years.

We hear a lot of horror stories about hysteroscopies however all our experiences are different and we're more likely to hear from those who found it more difficult. This can mean that for many (including me) the fear of it can be worse than it actually is. I took a couple of painkillers beforehand just in case and got someone to drive me to the hospital. I talked through any options for pain relief beforehand in case it might be needed which I found reassuring - these were gas and air and a local anaesthetic if at any point either I or the consultant thought it might be needed.

There was an uncomfortable moment when my cervix didn't want to let the hysteroscope through but I relaxed my lower stomach and through it went. I could then have a chat with no discomfort whatsoever with the consultant about the pesky marble sized fibroid that was the cause of my bleeding and what my options were. I did find the biopsy very stingy but it was over pretty quickly and that was that.

I don't really get what your consultant was meaning as my experience of the process was that the endometrial biopsy was the most uncomfortable thing.

....just to add/clarify I had no pain relief given and would do the same thing again. It helps to know it's there if needed though.

Thank you so much, it's so good to know not everyone finds it awful!

The endometrial biopsy, I didn't even know she was doing it. She said she wanted a look at my cervix and to take a biopsy. I thought it was a scrape of the cervix as it felt like a smear test, nothing more. When the results letter came through it said an endometrial biopsy so I queried this and she explained that, yes, she had passed a tiny vacuum suction thing into the uterus and sucked out some cells! So I'm presuming my cervix was accommodating!

I have been told to take two paracetamol before I go.

I have my hysteroscopies without anaesthetic (apart from, sometimes, a bit of local on the cervix as the probe goes through). I take ibuprofen and paracetamol before and it's fine. Not the most comfortable thing but bearable.

I find it helps to have a little self-hypnosis routine to go through: mine is walking down steps on to a beach at night, with the smell of jasmine and beautiful stars. It sounds weird but it helps me displace myself for a while. I actually quite like looking at the camera images once the probe is inside: it's just the getting through the cervix that is briefly not great.

Sound like you've had pretty much the equivalent of a hysteroscopy already. Good that your cervix is more accommodating than mine was - think it was making the Windows shut down noise at the same time! It can be an age thing 😐.

Hi Op
I will warn you that you will get lots of conflicting experiences here.

I have had both done and both almost painless. No worse than a smear.

I had a biopsy first, for some spotting, then some months later I had a hysteroscopy and biopsy (at the same time.)

Both were without any GA or local.

I was fine, and in all honesty it wasn't painful (and it took a long time as my cervix was closed firmly shut.) Evidently it ought to take about 10 mins, and mine took 30 mins.

I will add that it was done privately and I'd been seeing the consultant gynae for many years, so felt comfortable with him doing it. I had the choice of a GA, local, or nothing. I chose nothing, and the plan was to use a local if necessary or re schedule for a GA if needed.

I have heard that now it's possible to use a new technique without the speculum, and use the light on the camera to guide it in! That would make it a lot more comfortable.

Another small point, OP, the diameter of the tube used for the biopsy is pretty much the same as the camera/ scope. It' s about 3mm, and ideally they ought to be using the best/newest equipment available. I also think a lot depends on the skill of the dr doing it. I think that in my case, some less experienced drs may have abandoned it and had me back for a GA, but my dr was patient and very experienced.

ive had both - found the endometrial biopsy much more painful than hysteroscopy - take painkillers an hour before the procedure and relax!
I’ve had a polyp twice - they sometimes take out the polyp at the hysteroscopy if it’s small and you can bear it! Otherwise you go back for a local in the cervix - which is what I had recently (I had my first under GA 15 years ago but this time round they told me that the instruments are thinner now and no need for GA).
i felt fine after the camera but v wobbly after the polypectomy- dh was with me thankfully. I spotted for a week after - they messaged about 3 weeks later to say all was well as they send to histology as a matter of course.

@Serendipity09 i had one ten days ago.

I really worried and worked myself up, I get terrible anxiety around medical related things. It was absolutely fine. I had the hysteroscopy, a polyp removal which the consultant thinks might have been the thickening of my womb on the scan. I also had a biopsy and then after everything I had the mirena fitted.

During the procedure the nurses spoke to me all the way through, so much so that it really took my mind off the procedure. I told the consultant I was very nervous and he used a local anaesthetic gel and was super gentle. The main pain was just like a bad period pain. I did feel a bit faint afterwards but just lay down for my monitoring and after 20 minutes I was fine.
and have no worries about doing it all again.

honestly you will be absolutely fine xx

Also, do remember to take your pain killers before hand, I forgot and even then it was still ok. Also have something light to eat so you don’t feel dizzy after xx

Thank you all so much, you have really made me feel better. I just hope my blood pressure and pulse behave themselves this time. I just had so heavy bleeding last month that I need to get this sorted.

@over50andfab windows shut down noise? 🤔🤣

hi ladies, just need some reassurance as I’m very worried. I was referred for a hystroscopy and had it a few days ago as my lining is thick, dr said everything looked fine but she wanted to take a biopsy, this was agony. I was shocked as to why so didn’t ask any questions but I’m so worried, got so much anxiety.

any one had any experience of this and can share some positive stories.
thankyou

Please try not to worry. I had the same and all was fine. They know what they are looking for and if she said all was fine she is pretty certain that it is - she wouldn't say otherwise. The biopsy is just to confirm this. My doc said the same and said I 99% don't expect anything to be wrong but we have to double check.