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My Ob Gyn did a biopsy of the endometrium tissue and also of…

My Ob Gyn did a...
My Ob Gyn did a biopsy of the endometrium tissue and also of a polyp. She did this in the office with no numbing medication. When I asked if she was going to use a numbing agent she says it is very quick only a few minutes and it isn't needed. She did say I would have some cramping but only for a few minutes. I was able to tolerate it okay but my legs were very shaky when trying to walk. I think my body was trying to react to the pain. Is it common to do this without something to block pain?
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Answered in 4 minutes by:
3/9/2018
Dr. J
Dr. J, Board Certified OB/GYN
Category: OB GYN
Satisfied Customers: 543
Experience: Gynecologist
Verified

Hi Lisa. Board-certified obgyn here.

Preparing a response and will be with you shortly.

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In answer to your question, yes, it is pretty typical to do endometrial biopsies without administering any pain medicine or numbing medicine. And they can be very painful! (I know, I have had a few myself, unfortunately). But the process to numb the area can be just as crampy and painful as the biopsy itself (it involves injecting numbing medicine around the uterus), and it takes longer than just doing the biopsy (which typically just takes a couple of seconds).

I'm sorry it was so uncomfortable. I've been there! The cramps typically get better with time, but if you're still feeling crampy, the best medicine to take is Advil or Motrin.

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Customer reply replied 1 month ago
I was okay after it was done as far as cramps go. It was intense when she was actually doing it. The part I didn't like was feeling like I had jelly legs after and weak legs. What would cause that?

It's something called a vasovagal reaction - some women get it even from just a pap smear, let alone a biopsy. It's where the nerves around the uterus and cervix (mouth of the uterus) send pain signals to the brain which sort of cause your nervous system to "short out" - Your heart rate and blood pressure decrease and you can feel "funny" all over.

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Customer reply replied 1 month ago
That is a great explanation. Thanks for that. So would be on a calcium channel blocker and Losartan make this more pronounced? Normally on these meds, my bp isn't really that low.

It is possible - the calcium channel blocker causes the blood vessels in your legs to relax (causing them to be wider, and increasing blood flow to the area) so with that plus the vasovagal reaction decreasing your bp, the blood could have pooled in your legs (rather than traveling at its usual speed up to your brain) and caused your legs to feel funny.

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Customer reply replied 1 month ago
ok. May I ask another question concerning an endometrial polyp and spotting?

Sure.

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Customer reply replied 1 month ago
I am 53. I was having regular periods up til about 51. There were very heavy 3 days out of the week, but that I have had since I was young. I have several fibroids. At about 51, I started having spotting in between periods. At most the spotting may last 10 days and then say 2 weeks later may have again. My dr did an ultrasound and said I have a polyp which ended up being the biopsy referred to earlier. She also biopsied the endometrial lining. Both were negative. She did suggest I get this polyp removed at the time. I hadn't had a normal period for about 10 months just the spotting, but then in Jan. I had what I am pretty sure was a normal period as it was exactly like I have always had. The period was over for about 4 days and then spotting started and has been pretty continuous since about Feb 2. The spotting is very light sometimes I don't even wear a pad, because it stays up inside. I just notice when I wipe. Pads were getting irritating wearing continually so sometimes I try and take a break. I see my dr. again this week and I know she will suggest getting this out. I am so scared of surgery right now as I have chronic ebv and so many other goofy things going on drs can't diagnose. My body takes a hit with recovery from these sorts of things. She said because of the location of the polyp I would have to have general anesthesia with intubation. Never had this, but have a small mouth, tmj, and was told by an ENT doc that I may have a challenging intubation. I really don't want to do anything because this could just be entering menopause and maybe it will just go away. Is it possible just to let this go?

It is your body and you could choose to just ride things out and chalk everything up to menopausal changes, but I agree with your doc - it is worth evaluating. The average age of menopause in this country is 51 - this is when our female hormones go away and we stop having periods. Some women will go through this sooner; some later. But it gets kind of sticky in this age range because we never know if we can chalk it up to "just menopausal changes", or if there's actually something abnormal in there. If you have a polyp in your uterus, I always recommend removing the polyp. They are benign (not cancerous) the vast majority of the time, but it's a good idea to get it out to send it to the lab and know for sure. Plus it may help control all this irregular bleeding you've been having.

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Customer reply replied 1 month ago
I guess she was able to take a sample of the polyp during the biopsy and she said it was non cancerous. Is this accurated when done in an office setting like this? Also is it possible this polyp can go away? Couldn't she do a blood test to see if I am in menopause?

Getting a piece of the polyp and having it come back non-cancerous is great, but I still recommend removing the whole thing to know for sure. Polyps do not go away on their own - like when someone has a polyp in their colon, or on their vocal cords. They have to be removed to make sure the organ is healthy. You could do bloodwork to see if you're in menopause, but even if you're not in menopause, the polyp will still need to be removed.

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Customer reply replied 1 month ago
ok. I thought she had told me that they can sometimes shrink or go away but not the case?

Usually not. Sometimes I've had a patient pass the rest of the polyp after we remove a chunk of it during the biopsy. You could ask for an ultrasound beforehand to know for sure. Even if you've passed the polyp though, it sounds like you're having enough irregular bleeding to warrant a full evaluation of the rest of the uterine lining.

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Customer reply replied 1 month ago
say we did a blood test and it says I am not in menopause. Then could I just wait til I am in menopause and if I continue to bleed after then do something. I have read where you can watch and wait. I am saying this if the polyp isn't causing the problem and it is just fluctuation in hormones. I am just seeing what all of my options are as I am really trying to avoid this. It really is the anesthesia effects I am most concerned about.

It's your body and you can choose to do whatever you are comfortable with. I would recommend going ahead and doing the evaluation though. It is a quick outpatient procedure. I guess as gynecologists we see a lot of hyperplasia (precancer of the uterus) and then also cancer of the uterus so we do not feel very comfortable just waiting for things to get better. I understand your concerns about the anesthesia, but it is a pretty simple, straightforward procedure. Perhaps you could talk to your doc to see if there are options besides being intubated with general anesthesia for the procedure?

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Customer reply replied 1 month ago
I know the actual procedure isn't too bad, but anesthesia to me is like having major surgery because of the risk involved with that. I can see if I could do a spinal block possibly. I sure wish she could just numb me with lidocaine and take it out in the office.

Maybe she can! I would have a serious talk about that with her. You could also ask to be referred to an office where this procedure can be done in the office - there are some offices where this can be done. It sounds like you're open to the procedure but the anesthesia concerns you. You could also ask to meet with the anesthesiologist ahead of time to see if there'a options besides intubating you with general anesthesia.

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Customer reply replied 1 month ago
sounds good. Thanks for the info.
Customer reply replied 1 month ago
Oh one last thing. She did say it was very high in the uterus and that is why it required general but I will check again.

You are most welcome. I wish you all the best and I hope all goes well.

If you are satisfied with the response received, please leave a rating by clicking the stars above. Thank you so much.

Dr. J
Dr. J, Board Certified OB/GYN
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