Cervical biopsies can be painful. Pain levels depend on several factors, including the type of biopsy and whether doctors administer pain relief during the procedure.
A cervical biopsy involves removing tissue samples from a person’s cervix and sending them for laboratory testing to determine whether any cells are atypical or potentially cancerous.
Doctors recommend these biopsies for people who test positive for human papillomavirus (HPV) or if there are atypical findings during a pelvic exam or Pap smear. They provide doctors with important information, but they can be painful.
This article discusses pain associated with a cervical biopsy. It also describes pain relief options, recovery, potential side effects, aftercare, and the average waiting time for results.
A randomized controlled trial from 2017 attempted to determine whether an injection of a local anesthetic was more painful than a cervical punch biopsy without local anesthesia.
The study used a visual analog scale (VAS) to measure pain levels. This is a system where people rate their pain on a scale of 0–10, with zero indicating no pain and 10 indicating the worst pain possible.
The results of the study were as follows:
| Procedure | Average VAS score |
|---|---|
| Injection of local anesthetic | 2.7 (mild pain) |
| Cervical punch biopsy without local anesthesia | 3.5 (mild to moderate pain) |
| Cervical biopsy with local anesthesia | 0.8 (no pain to very mild pain) |
Biopsy types
The type of procedure may affect the pain levels. There are several ways a doctor can perform a cervical biopsy:
- Endocervical curettage (ECC): A doctor uses an instrument called a curette to scrape tissue samples from the lining of the endocervical canal. Doctors generally
do not use anesthesia for this method. A person may feel a light pinch or cramp. - Punch biopsy: A doctor removes a small tissue sample using a circular blade similar to a paper hole punch. People may feel discomfort or mild pain. This procedure may or may not require a local anesthetic to numb the skin, but the person will be awake.
- Cone biopsy: A doctor uses a scalpel or laser to remove a
large, cone-shaped tissue sample from the cervix. This procedure requires a general anesthetic, so a person will be asleep and will not feel any pain.
Instruments
The tools a doctor uses to perform the procedure may also impact pain levels. Doctors may use a variety of instruments, such as:
- a speculum to hold the vagina open so that the cervix is visible
- a colposcope to view cervical tissues
- a needle to inject pain medication
- forceps to hold the cervix in place while they remove the tissue sample
- a tool to remove the tissue samples, such as a scalpel, laser, curette, or circular blade
In addition to pain, a person undergoing a cervical biopsy without sedation or anesthesia might feel cramping, pinching, or burning, depending on the tools the doctor uses.
Injection of a local anesthetic may offer pain relief during a cervical biopsy.
While the injection itself can cause some pain, a 2017 study found that those who had an anesthetic injection before a cervical punch biopsy experienced less pain overall than those who had a biopsy with no anesthesia.
Lidocaine spray is another pain relief option for people having a cervical biopsy. A 2021 study found that participants experienced only a small amount of pain reduction from lidocaine spray but that the intervention was safe.
A person can ask a healthcare professional about their pain management options for before and after the procedure, such as whether they can use non-steroidal anti-inflammatory drugs (NSAIDs).
The type of biopsy a person has can affect how long they experience pain afterward. With less invasive methods, such as a punch biopsy or ECC, a person will likely not experience pain for long.
The United Kingdom’s National Health Service states that a person may need to take over-the-counter (OTC) painkillers during the 24 hours after a punch biopsy.
After a cone biopsy, a person will likely have period-type pain and cramping for a couple of hours. Medical professionals can prescribe pain relief for this.
Aftercare for cervical biopsies varies depending on the type of biopsy.
ECC and punch biopsies
A person may be able to resume their typical activities relatively quickly after having ECC or a punch biopsy. They may need to take OTC pain relief in the first 24 hours.
People may have discolored discharge and light bleeding in the days following a punch biopsy. The discharge may take up to a week to clear up.
Cone biopsies
Recovery may take longer after a cone biopsy. A person may experience bleeding for 4–6 weeks.
A doctor will recommend the length of time during which a person will need to avoid:
- douching
- tampon use
- sexual intercourse
- heavy lifting
- excess physical activity
- water immersion, such as in baths, pools, or hot tubs
Some biopsies require packing with gauze, similar to a tampon, to manage bleeding. A doctor will provide instructions on how to remove it safely.
Signs of infection
Like any surgical procedure, a surgical biopsy carries a risk of infection. Signs that a person should seek medical care include:
- severe abdominal pain
- excess or prolonged bleeding
- fever
- chills
- strong-smelling vaginal discharge
Excessive bleeding could be a sign that a person is engaging in too much activity too soon after their procedure. However, fever, pain, and a strong odor could indicate an infection, which requires prompt medical attention.
This section answers some common questions about cervical biopsies.
What is the average waiting time for cervical biopsy results?
The wait time for cervical biopsy results can range from several days to several weeks.
The healthcare professional who performs the procedure can provide an estimated wait time specific to the individual’s situation.
What is the recovery time for a cervical biopsy?
Recovery time will depend on the type of procedure a person has.
After a less invasive form of procedure, such as a punch biopsy or endocervical curettage (ECC), a person will likely recover quickly. They may need to take OTC painkillers, such as acetaminophen or ibuprofen, during the 24 hours after the biopsy.
People may experience discolored discharge and light bleeding in the days following a punch biopsy. The discharge may take up to a week to clear up.
A person will likely take 4–6 weeks to recover completely after a cone biopsy. They may experience bleeding during this time and will need to avoid vigorous activity and sexual intercourse.
However, they will likely feel better and be able to return to their other typical activities after 1–2 weeks.
Women’s health resources
Visit our dedicated hub for more research-backed information and in-depth resources on women’s health.
A cervical biopsy is an important diagnostic tool that can identify cancer. However, cervical biopsies can be painful if a person does not undergo anesthesia.
There are several types of biopsies, which cause varying degrees of discomfort and have different aftercare requirements.
Anyone who needs a cervical biopsy can ask a doctor about pain management options.