Endometrial Biopsy

Why It Is Done

An endometrial biopsy is done to:

• Check for cancer of the uterus.
• Find the cause of heavy, prolonged, or irregular uterine bleeding. It is often done to find the cause of uterine bleeding in women who have gone through menopause.
• See whether the lining of the uterus (endometrium) is going through the normal menstrual cycle changes.

How To Prepare

Tell your doctor if you:

• Are or might be pregnant. An endometrial biopsy is not done during pregnancy.
• Are taking any medicines.
• Are allergic to any medicines.
• Take a blood thinner, or if you have had bleeding problems.
• Have been treated for a vaginal, cervical, or pelvic infection.
• Have any heart or lung problems.

Do not douche, use tampons, or use vaginal medicines for 24 hours before the biopsy. You will empty your bladder just before your biopsy.

You may want to take a pain reliever, such as ibuprofen (Advil or Motrin), 30 to 60 minutes before having the biopsy. This can help decrease any cramping pain that can be caused by the biopsy.

You will be asked to sign a consent form that says you understand the risks of the test and agree to have it done.

Talk to your doctor about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results may mean. To help you understand the importance of this test, fill out the medical test information form (What is a PDF document?).

How It Is Done

Endometrial biopsy

An endometrial biopsy is usually done by a gynecologist, a family medicine physician, or a nurse practitioner who has been trained to do the test. The sample will be looked at by a pathologist. The biopsy can be done in your doctor's office.

You will need to take off your clothes below the waist. You will be given a covering to drape around your waist. You will then lie on your back on an examination table with your feet raised and supported by foot rests (stirrups).

Your doctor will insert a lubricated tool called a speculum into your vagina. The speculum gently spreads apart the vaginal walls so your doctor can see inside the vagina and the cervix. The cervix is washed with a special solution and may be grasped and held in place with a clamp called a tenaculum.

Your cervix may be numbed with a spray or injection of local anesthetic.

The tool to collect the sample is guided through the cervix into the uterus. The tool may be moved up and down to collect the sample. Most women have some cramping during the biopsy.

An endometrial biopsy takes 5 to 15 minutes.

How It Feels

Endometrial biopsy

You may feel a sharp cramp as the tool is guided through your cervix. You may feel more cramping when the biopsy sample is collected. Most women find that the cramping feels like a really bad menstrual cramp.

Some women feel dizzy and sick to their stomachs. This is called a vasovagal reaction. This feeling will go away after the biopsy.

An endometrial biopsy usually causes some vaginal bleeding. You can use a pad for the bleeding or spotting.

What Affects the Test

Reasons you may not be able to have the endometrial biopsy or why the results may not be helpful include:

• If you are pregnant. An endometrial biopsy is not done during pregnancy.
• If a vaginal or cervical infection is present. The infection could spread to the uterus if an endometrial biopsy is done.
• If the endometrial biopsy sample is not large enough to see abnormal cells. Another test may be needed.

What To Think About

• An endometrial biopsy is not done during pregnancy.
• More of the uterine lining can be sampled during a dilation and curettage (D&C) than during an endometrial biopsy. Another test, called a hysteroscopy, is usually done with a D&C so that your doctor can see the lining of your uterus. A hysteroscopy may also be done instead of a D&C. To learn more, see the topic Hysteroscopy.
• An endometrial biopsy is not usually done during or after menopause unless a woman has abnormal vaginal bleeding.