What is an endometrial biopsy?
An endometrial biopsy, also known as a uterine biopsy, is a procedure in which a small sample of tissue is removed from the lining of your uterus, also called the endometrium. Once removed, your doctor can look at the tissue under a microscope to determine the cause of the abnormal uterine bleeding. It can also tell if the cause of the bleeding is a sign of endometrial cancer or uterine cancer.
Like a Pap smear, an endometrial biopsy is a simple procedure performed in your doctor’s office during a pelvic exam. It is a safe and relatively quick procedure.
Why might I need an endometrial biopsy?
The most common reason providers order endometrial biopsies is to investigate abnormal bleeding, often caused by endometrial polyps. However, these procedures can also help healthcare professionals check for cancer.
How to prepare for an endometrial biopsy
In the days before your endometrial biopsy, you may be asked to follow these guidelines:
- Do not use vaginal creams or other medications for at least two days before the procedure.
- Do not use tampons for at least a day before the procedure.
- Do not douche.
- If you have not gone through menopause, you will need to take a pregnancy test. (A biopsy cannot be performed if you are pregnant.)
- If you take aspirin or any other blood-thinning medications, ask your provider if you need to stop taking them.
Your OBGYN may provide additional instructions. Make sure you follow all the instructions at the appropriate times.
The endometrial biopsy procedure
An endometrial biopsy is an outpatient procedure that can take place in your OBGYN’s office or another outpatient facility without anesthesia.
What are the risks of an endometrial biopsy?
The risks of an endometrial biopsy are very low. There is a small risk of infection or poking a small hole in the uterus, known as uterine perforation. Call your OBGYN if you experience any of the following symptoms:
- Fever
- Heavy bleeding
- Lower abdominal pain
- Vaginal discharge with a strong odor
Understanding the results
A pathologist will evaluate your endometrial tissue sample in a laboratory. It may take a week or two to receive your endometrial biopsy results. If the biopsy does not show cancerous cells, you need to talk to your doctor about the next steps, which may involve medications or another procedure to treat your bleeding.
If there are cancerous cells present, an abnormal result, you will be referred to gynecologic oncology for further management. Potential causes of abnormal results include:
- Uterine polyps
- Infections in the uterine lining
- Hormonal imbalances
- Endometrial cancer or precancer (hyperplasia)
In some cases, the results may be inconclusive. Your healthcare provider might recommend a procedure called dilation and curettage (D&C) to remove a larger tissue sample for further examination or to continue to investigate any symptoms.