Can an endometrial biopsy cause nausea and vomiting?

Nausea and Vomiting Following Endometrial Biopsy

Endometrial biopsy is not typically associated with nausea and vomiting as a common complication within a few days after the procedure.

Understanding Endometrial Biopsy Complications

Endometrial biopsy is a common office procedure used for evaluating the endometrium, particularly for abnormal uterine bleeding and postmenopausal bleeding. While the procedure is generally safe, it does have some associated adverse effects:

Common Complications:

• Cramping (most common adverse effect) 1
• Vaginal bleeding
• Pelvic pain

Rare but Serious Complications:

• Infection (extremely rare)
• Septic shock (case reports only) 2, 3
• Uterine perforation (rare)

Nausea and Vomiting in Context

The medical literature and guidelines do not specifically identify nausea and vomiting as expected complications following endometrial biopsy:

1. The comprehensive review of endometrial biopsy complications in American Family Physician does not list nausea and vomiting among the expected adverse effects 1

2. Even case reports of severe complications following endometrial biopsy (such as septic shock) focus on fever, pain, and bleeding rather than nausea and vomiting as presenting symptoms 2, 3

3. Guidelines on gynecologic procedures and endometrial sampling do not include nausea and vomiting in their discussion of post-procedure complications 4

When to Consider Other Causes

If a patient experiences nausea and vomiting within a few days after an endometrial biopsy, consider:

Possible Infection:

• Evaluate for other signs of infection such as fever, increased pain, or abnormal vaginal discharge
• Rare but serious infections like group A streptococcal toxic shock syndrome have been reported after endometrial biopsy 2
• Atypical symptoms like persistent abdominal pain could indicate infectious complications 3

Vasovagal Response:

• Some patients may experience delayed vasovagal symptoms
• Usually self-limiting and resolves within 24 hours

Medication Side Effects:

• Consider if pain medications were prescribed post-procedure
• NSAIDs can cause gastrointestinal upset in some patients

Management Approach

If a patient reports nausea and vomiting after endometrial biopsy:

1. Assess for signs of infection (fever, severe pain, abnormal discharge)
2. Evaluate vital signs for tachycardia or hypotension
3. Consider antiemetics if symptoms are troublesome
4. Ensure adequate hydration
5. Seek prompt medical attention if accompanied by severe pain, fever, or signs of infection

Conclusion

While nausea and vomiting are not typically expected complications following endometrial biopsy, they may occur in rare cases. When they do occur, they warrant evaluation to rule out more serious complications such as infection. Most post-endometrial biopsy symptoms are mild and self-limiting, with serious complications being exceedingly rare.