Endometrial Biopsy

What is an endometrial biopsy?

A tissue sample is taken from the lining (endometrium) of the uterine cavity. The endometrial tissue is sent for examination to a pathologist to look for abnormal cells.

Reasons to have an endometrial biopsy:

  • Abnormal menstrual bleeding
  • Irregular menstrual cycles or lack of cycles
  • Bleeding after menopause

Biopsy may help us diagnose cell changes due to hormone imbalance, or growths such as polyps, as well as precancerous and cancerous cells.

Risks of an endometrial biopsy?

There is a small chance that the uterus could be punctured during the biopsy. Bleeding, pain, or a pelvic infection can also occur.

Preparing for an endometrial biopsy?

Please make sure you have had something to eat before you come to the office for your appointment. If you are hungry when we perform the procedure, you may feel faint and can pass out during the process.

30 minutes before your appointment, please take 800 mg of Ibuprofen (Advil or Motrin). This will help ease cramping you may have during and after the procedure.

If appropriate, your provider may prescribe Misoprostol to be taken several hours prior to your scheduled appointment. Misoprostol can dilate the cervix and may allow for easier sampling of the endometrium. Please follow the instructions on your prescription.

What to expect during the biopsy?

The biopsy is done in the office. We may ask you for a urine specimen prior to the procedure to confirm you are not pregnant. You will be asked to undress from the waist down and to lie on the exam table, with your feet and legs supported in a foot rest.

A speculum will be used to hold the vaginal walls apart so that the cervix can be seen. After cleaning your cervix with betadine solution, your provider may numb the area using a small needle to inject an anesthetic. Forceps may be used to steady the cervix for the biopsy. Your provider will then insert a thin tube (pipette) through the cervical opening into the uterus. The pipette has a smaller tube inside it. When the inner tube is pulled back, suction is created inside the uterus allowing endometrial tissue to be pulled into the sampling tube. This may cause some cramping.

After the biopsy?

It is normal to have some cramping and spotting or bleeding for a few days after the procedure. You can continue to take ibuprofen after the procedure -- usually 600mg every 6-8 hours as needed. Don’t put anything into the vagina for 2-3 days after an endometrial biopsy.
Tell your healthcare provider if you have any of the following:

  • Excessive bleeding, or prolonged bleeding
  • Foul-smelling discharge from your vagina
  • Fever or chills
  • Severe lower belly pain