Patient education: Endometrial biopsy (The Basics)

What is an endometrial biopsy? — 

This is a procedure to check cells from the inner lining of the uterus, called the "endometrium" (figure 1). The uterus is the organ that holds a baby when a person is pregnant.

You might have an endometrial biopsy to:

●Help figure out the cause of abnormal vaginal bleeding

●Check for endometrial cancer or precancer

●Help plan treatment for a medical problem, or see how treatment is working

Most endometrial biopsies are done in a doctor's office or clinic. In some cases, the biopsy is done in a procedure center or hospital.

How do I prepare for an endometrial biopsy? — 

The doctor or nurse will tell you if you need to do anything special to prepare. Before the procedure, your doctor will do an exam.

They will also ask about your "health history." This involves asking about any health problems you have or had in the past, past surgeries, and any medicines you take. Tell them about:

●Any medicines you are taking – This includes prescription or "over-the-counter" medicines, plus any herbal supplements. It helps to write down and bring a list of your medicines, or bring a bag with all your medicines with you.

●Any allergies you have

●Any bleeding problems you have – Certain medicines, including some herbs and supplements, can increase the risk of bleeding. Some health conditions also increase this risk.

You will also get information about:

●Eating and drinking before the procedure – You can probably eat and drink normally before the procedure.

●If you need to stop taking any medicines for a time before the procedure – Follow the doctor's instructions carefully.

●If you need to take any medicines before the procedure – The doctor might suggest taking a non-prescription pain medicine about 30 to 60 minutes before the procedure. Examples include ibuprofen (sample brand names: Advil, Motrin) and naproxen (sample brand name: Aleve).

Ask the doctor or nurse if you have questions or if there is anything you do not understand.

What happens during an endometrial biopsy? — 

When it is time for the procedure:

●You will lie on an exam table with your knees bent and your feet in footrests.

●The doctor will do a pelvic exam. This involves checking your vagina, cervix, and uterus. The cervix is the bottom part of the uterus where it meets the vagina.

●The doctor will use a tool called a "speculum" to hold the walls of your vagina open. They will clean your cervix to prevent infection.

●They might need to gently open your cervix, then give you an injection (shot), or use a topical spray or gel, to numb it. Then, they will insert a tool called a "suction curette" into your uterus to remove a small sample of your endometrium. The sample will be sent to a lab for testing. The doctor might take more than 1 sample.

●They will remove the tools and stop any bleeding.

●Most endometrial biopsies take only a few minutes.

What happens after an endometrial biopsy? — 

You might need to rest for a few minutes to make sure you do not feel faint. As long as you are feeling well and do not have heavy bleeding, you can probably go home and resume your normal activities.

After a biopsy:

●You might have some light vaginal bleeding for a few days. Your doctor will tell you if you should use pads or panty liners rather than a tampon or menstrual cup.

●If you have cramping, take pain medicines such as ibuprofen (sample brand names: Motrin, Advil) and naproxen (brand name: Aleve). You can also put a heating pad or hot water bottle on your lower belly.

●Your doctor will tell you if you should avoid vaginal sex or putting anything in your vagina for a few days.

●Your doctor will tell you when to expect your results and what they mean.

What are the risks of an endometrial biopsy? — 

Endometrial biopsy is very safe, but problems can happen.

Your doctor will talk to you about all the possible risks, and answer your questions. Possible risks include:

●Bleeding

●Infection

●Injury to the uterus or cervix

When should I call the doctor? — 

Call for advice if you have:

●A fever of 100.4°F (38°C) or higher, or chills

●Heavy vaginal bleeding that lasts more than an hour – This means bleeding that is heavier than a menstrual period, or that completely soaks a large pad.

●Vaginal bleeding that lasts longer than 7 days

●Bad-smelling vaginal discharge

●Pelvic pain or cramping that does not improve with pain medicines

More on this topic

Patient education: Heavy periods (The Basics)
Patient education: Uterine cancer (The Basics)
Patient education: Pelvic exam (The Basics)
Patient education: Dilation and curettage (D&C) (The Basics)

Patient education: Abnormal uterine bleeding (Beyond the Basics)
Patient education: Heavy periods (Beyond the Basics)
Patient education: Endometrial cancer diagnosis, staging, and surgical treatment (Beyond the Basics)
Patient education: Dilation and curettage (D&C) (Beyond the Basics)