This is not a witch-hunt—but it is a wakeup call. Cervical biopsies are a critical tool in the arsenal of women’s health care, but the argument that “most women do just fine without painkillers” doesn’t address the fact that many definitely do not. It’s hard not to feel that our pain isn’t being blown off and brushed aside. At the very least, women should be better informed about what they’re in for, instead of being allowed to walk into a procedure that has the potential to be traumatizing.
What are doctors doing to prepare women for cervical biopsies?
There are no official guidelines for pain management during a cervical biopsy other than the ACOG recommendation to take some ibuprofen 30 minutes prior to the procedure. Philips uses lidocaine spray to partially numb the cervix and also tries to “manage a patient’s expectations for the discomfort by explaining that some people have discomfort and some do not. I also tell them how much time I expect the procedure to last so they can manage the time in their heads. It helps to know we won’t be taking biopsies forever,” she says. “The medical community certainly takes women’s pain seriously. No one likes pain and we try to be very mindful of it—but with cervical biopsies, it is hard to predict who will have pain.”
What You Can Do About It
A good doctor will explain the procedure and let you know what to expect before pulling out a pair of scary-looking forceps. Most of the women I spoke to said their doctors did that—but ultimately it’s up to you to ask questions and advocate for yourself while your feet are in the stirrups.
“If you can, premedicate with 600 to 800 mg of ibuprofen,” says Sherri Ross, M.D., an ob-gyn and author of She-ology. “That is helpful along with asking the doctor to numb the cervix with a lidocaine injection or spray.” Before you have a cervical biopsy, she advises asking the following questions:
1. What are you seeing on my cervix or Pap smear that makes you want to do a cervical biopsy? Are your concerns related to the HPV virus?
2. What does this type of cervical biopsy entail? Please walk me through the process.
3. How long does it take, and will I experience any pain or uncomfortable symptoms?
4. What painkillers are available to make the procedure less uncomfortable?
5. What complications of a cervical biopsy should I be aware of?
6. What should I expect after having the biopsy? Should I bleed after a cervical biopsy?
7. What will the results tell me? Will you or your nurse call me with normal or abnormal results?
8. When can I have sex, use tampons, or take a bath after having a cervical biopsy?
Another good tip: Bring a support person. “If I could give advice to anyone dealing with the process, it would be to not deal with it alone, and bring someone with them to the appointments. I did everything on my own, and literally had a meltdown after,” says Dava, 37.
Most importantly, never be afraid to speak up—no medical procedure should leave you feeling traumatized. Ask your doctor to walk you through what she’s doing every step of the way, speak up if you’re in more pain than you can handle, and insist that your doctor provide a painkiller if you need it. “Women need to empower themselves and be their best health care advocates,” says Ross. “It’s important to ask a lot of questions so you fully understand what is happening. If your health care provider is not helpful or cooperative with your questions, get a second opinion or find a provider who makes this an easy process—because it really should be.”