Re: transvaginal ultrasound & endometrial biopsy
Yes I remember going through my biopsy and it was not pleasant. My doctor had to use a clamp to keep the cervix open and this is what hurt the most. Felt like an extremely sharp needle being inserted into my skin. The tighter the cervix (ie. if you have not had children) the more painful the biopsy. Before I went for mine, I read up on the procedure and took 2 ibuprofen one hour before so as to negate the cramping. Doctors should suggest this to patients but they don't. I had absolutely no cramping after the procedure whatsoever ... just spotting for a few days. Of course my poor cervix felt like someone had stretched it out of shape and this took a few hours to feel normal again. All that said, the biopsy is very important so as to rule out the possibility of endometrial hyperplasia or even uterine cancer.
As for the ultrasound, are you having an external ultrasound or an internal one ? The external one is just having some jelly put on your pelvis and a wand slid across it. For the internal one, the wand is placed in the vagina .. it is a small wand and when I had mine, it was painless. For the external, you have to drink 32 ounces of water an hour before the procedure and not go to the bathroom. For the internal, you have to empty your bladder beforehand (ie. the opposite). The ultrasounds are nothing compared to the biopsy so I don't think you need to worry.
The ultrasound will look at the thickness of your endometrial lining to see if perhaps a very thick lining is causing your spotting. If you have a choice, try to go for the US around the time of your period (if external) or a few days after the start of your period (after most of the bleeding is done if internal). This will reduce the risk of them seeing ovarian cysts on the US. Ovarian follicles (or cysts) are completely normal things that come and go with your cycle. During your menses is when you are the least likely to see them as this is when your body withdraws hormones in order to clean out your uterus (ie. your period).
Just go for the ultrasound. Yeah the spotting is probably not life threatening but you still want to find out why it is happening. Thickened uterine linings over a long period of time can turn into endometrial hyperplasia and then possibly cancer. Simply cleaning out a thickened lining (either by taking progesterone or with a D & C) can prevent all of that. If this is what you have, you could possibly be preventing a future serious problem from occuring.
Hope this helps ... oh and after the ultrasound, be sure to clean out your bellybutton from the vaseline (if an external one).