An endometrial biopsy is the removal of a small piece of tissue from the endometrium, which is the lining of the uterus. This tissue sample can show cell changes due to abnormal tissues or variations in hormone levels.
Taking a small sample of endometrial tissue helps your doctor diagnose certain medical conditions. A biopsy can also check for uterine infections such as endometritis.
An endometrial biopsy can be performed in the doctor’s office without the use of anesthesia. Typically, the procedure takes about 10 minutes to complete.
An endometrial biopsy may be performed to help diagnose abnormalities of the uterus. It can also rule out other diseases.
Your doctor may want to perform an endometrial biopsy to:
- find the cause of postmenopausal bleeding or abnormal uterine bleeding
- screen for endometrial cancer
- evaluate fertility
- test your response to hormone therapy
You can’t have an endometrial biopsy during pregnancy, and you shouldn’t have one if you have any of the following conditions:
- a blood clotting disorder
- acute pelvic inflammatory disease
- an acute cervical or vaginal infection
- cervical cancer
- cervical stenosis, or severe narrowing of the cervix
Endometrial biopsy during pregnancy can lead to miscarriage. Tell your doctor if you’re pregnant or if there’s a chance you may be pregnant. Your doctor might want you to take a pregnancy test before the biopsy to ensure that you aren’t pregnant.
Your doctor may also want you to keep a record of your menstrual cycles before the biopsy. This is usually requested if the test needs to be done at a particular time during your cycle.
Tell your doctor about any prescription or over-the-counter medications you are taking. You might have to stop taking blood thinners before an endometrial biopsy. These medications can interfere with the blood’s ability to clot properly.
An endometrial biopsy can be uncomfortable. Your doctor may recommend that you take ibuprofen (Advil, Motrin) or another pain reliever 30 to 60 minutes before the procedure.
Your doctor may also give you a light sedative before the biopsy. The sedative may make you drowsy, so you shouldn’t drive until the effects have fully worn off. You may want to ask a friend or family member to drive you home after the procedure.
Before the biopsy, you’re provided with a robe or medical gown to put on. In an exam room, your doctor will have you lay on a table with your feet in stirrups. They then do a quick pelvic exam. They also clean your vagina and cervix.
Your doctor may put a clamp on your cervix to keep it steady during the procedure. You might feel pressure or slight discomfort from the clamp.
Your doctor then inserts a thin, flexible tube called a pipelle through the opening of your cervix, extending extend several inches into the uterus. They next move the pipelle back and forth to get a tissue sample from the lining of the uterus. The entire procedure typically takes about 10 minutes.
The sample of tissue is put in fluid and sent to a laboratory for analysis. Your doctor should have the results approximately 7 to 10 days after the biopsy.
You may experience some light spotting or bleeding after the procedure, so you’ll be given a menstruation pad to wear. Mild cramping is also normal. You may be able to take a pain reliever to help with cramping, but be sure to ask your doctor.
Don’t use tampons or have sexual intercourse for several days after an endometrial biopsy. Depending on your past medical history, your doctor might provide you with additional instructions after the procedure.
Like other invasive procedures, there’s a small risk of infection. There’s also a risk of puncturing the uterine wall, but this is very rare.
Some bleeding and discomfort is normal. Call your doctor if you have any of the following symptoms:
- bleeding for more than two days after the biopsy
- heavy bleeding
- fever or chills
- severe pain in the lower abdomen
- abnormal or unusual-smelling vaginal discharge
An endometrial biopsy is normal when no abnormal cells or cancer is found. Results are considered abnormal when:
- a benign, or noncancerous, growth is present
- a thickening of the endometrium, called endometrial hyperplasia, is present
- cancerous cells are present