Is a cervical biopsy painful?

From the Guidelines

A cervical biopsy can be painful for some women, with about 28% reporting moderate or more severe pain during the procedure. According to the study published in the Annals of Internal Medicine 1, this pain is often accompanied by post-procedure bleeding of at least moderate severity in 22% of cases. The procedure typically involves a colposcopy with biopsy, and the pain experienced can vary depending on individual pain tolerance and the specific technique used.

Some key points to consider about the pain associated with cervical biopsy include:

• The pain is usually mild to moderate and temporary, lasting only a few minutes during the procedure
• Local anesthetics can be used to numb the cervix before taking the tissue sample, reducing pain
• Over-the-counter pain medications like ibuprofen or acetaminophen can help manage discomfort before and after the procedure
• Individual experiences of pain vary, and discussing concerns with a healthcare provider beforehand can help identify additional pain management options

It's also important to note that while the pain from a cervical biopsy is a consideration, the potential benefits of the procedure in terms of detecting and treating cervical cancer or precancerous lesions can outweigh the temporary discomfort. As such, it is recommended that women undergo cervical biopsy as directed by their healthcare provider, using pain management strategies as needed to minimize discomfort. This approach prioritizes the detection and treatment of cervical cancer, which can significantly impact morbidity, mortality, and quality of life 1.

From the Research

Cervical Biopsy Pain

• Cervical biopsy can be a painful procedure, but various methods can be used to reduce the discomfort associated with it 2, 3, 4, 5, 6.
• The use of local anesthesia, such as lidocaine, has been shown to be effective in reducing pain during cervical biopsy 2, 3, 4, 5.
• Other methods, such as forced coughing, have also been found to be effective in reducing pain and anxiety associated with cervical biopsy 3, 6.
• The efficacy of different pain relief methods can vary, and some studies have found that certain methods, such as intrauterine lidocaine, may be more effective than others 5.
• The use of pain relief methods can also reduce the need for additional analgesia and decrease the patient's fear of future procedures 5, 6.

Pain Relief Methods

• Local anesthesia (e.g. lidocaine) can be applied topically or injected into the cervix to reduce pain during biopsy 2, 3, 4, 5.
• Forced coughing can be used as a pain-reducing technique during cervical punch biopsy 3, 6.
• Intrauterine lidocaine has been found to be effective in reducing pain during endometrial biopsy 5.
• Paracervical block with prilocaine has also been found to be effective in reducing pain during endometrial biopsy 5.

Study Findings

• A study published in 2016 found that cervical 2% lidocaine gel was simple and effective for decreasing pain associated with Pipelle endometrial biopsy 2.
• A study published in 2008 found that forced coughing reduced patients' discomfort to the same extent as local anesthesia, but was associated with a significantly reduced examination time 3.
• A study published in 2003 found that injection of lidocaine resulted in a reduction in pain scores for cervical biopsies, endocervical curettage, and overall procedure scores 4.
• A study published in 2025 found that intrauterine lidocaine and paracervical block were more effective than lidocaine spray and oral dexketoprofen in reducing procedural pain during endometrial biopsy 5.
• A study published in 2018 found that forced coughing provided significant pain relief during cervical punch biopsy and reduced the patients' fears and desires for pain medications in future procedures 6.