Endometrial Biopsy

What Is an Endometrial Biopsy?

The lining of the uterus is called the endometrium. The endometrium can indicate cell changes in response to hormone levels, as well as, any abnormal tissue such as fibroids. Taking a small sample, called a biopsy, of endometrial tissue can help diagnose certain medical conditions. It can also be used to check for uterine infections.

An endometrial biopsy is a short procedure, typically only taking about 10 minutes. It can be performed in the doctor’s office without the use of anesthesia.

Why Is an Endometrial Biopsy Performed?

An endometrial biopsy may be performed to help diagnose abnormalities of the uterus. It is also done to rule out other diseases. Common reasons for an endometrial biopsy include:

  • abnormal uterine bleeding
  • postmenopausal bleeding
  • screening for endometrial cancer after finding atypical cells
  • evaluating fertility
  • checking a response to hormone therapy
  • abnormal Pap smear result

Conditions during which an endometrial biopsy is not recommended include:

  • pregnancy
  • acute pelvic inflammatory disease
  • patients with a clotting disorder
  • acute cervical or vaginal infection
  • cervical cancer
  • morbid obesity
  • severe narrowing of the cervix, called stenosis

How Do I Prepare for an Endometrial Biopsy?

There is not much preparation needed for this procedure. For your comfort, your doctor may suggest taking ibuprofen or another NSAID an hour or two before the procedure.

Tell your doctor if you are pregnant or if there is a chance you may be pregnant. Your doctor may want you to take a pregnancy test before the biopsy.

Tell your doctor about any medications you are taking or if you have any allergies, including allergies to latex or iodine, before the procedure. Your doctor will also want to know whether you have any bleeding disorders. You might have to stop taking blood-thinning medications before an endometrial biopsy.

Additionally, your doctor may also want you to keep a record of your menstrual cycles. This is because the test may be required at a particular time during your cycle.

If your doctor prescribes a light sedative, you will need someone to drive you to and from the procedure. Otherwise, you will be able to drive yourself.

What Happens During an Endometrial Biopsy?

After you are led to the exam room, you will be asked to undress from the waist down and will be given a robe or medical gown. You will lie on the table with your feet in stirrups, and your doctor will do a pelvic exam before the biopsy.

After cleaning your vagina and cervix, the doctor might put a clamp on your cervix to keep it steady during the procedure. You might feel pressure or slight discomfort from this. A thin, flexible, sterile tube called a pipelle will then be inserted through the opening of your cervix, going several inches into the uterus.

The doctor will pull a thin wire out of the center of the pipelle to create suction. He or she will then move the pipelle back and forth to get a sample of tissue from the lining of the uterus. The procedure typically takes about 10 minutes.

The sample is then put in fluid for laboratory examination. Your doctor should have the results in approximately 7 to 10 days after the biopsy.

Are There Any Risks Associated with the Procedure?

It is normal to experience some light spotting or bleeding after the procedure, so your doctor will give you a sanitary pad to wear. Mild cramping is also normal. Do not use tampons or have intercourse for several days after an endometrial biopsy, or as instructed by your doctor.

With any invasive procedure, there is a small risk of infection. There is also the risk of puncturing the uterine wall, but this is very rare.

While some bleeding and discomfort is normal, you should call your doctor if you have these symptoms:

  • bleeding for more than two days post-biopsy
  • heavy bleeding
  • fever or chills
  • severe pain in lower abdomen
  • abnormal or foul-smelling vaginal discharge

Depending on your past medical history, your doctor might provide you with other information or instructions about the procedure or after-care.

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