What is an Endometrial Biopsy?

The endometrium is the lining of the uterus. During ovulation, this lining thickens to provide a fertilized egg with a nutrient-rich environment. The endometrium is also subject to diseases such as cancer and endometriosis. During an endometrial biopsy, a sample of endometrial tissue is obtained for laboratory examination, to determine whether any disease is present.

An endometrial biopsy may be carried out for several reasons. This procedure is indicated when a woman experiences heavy, irregular, or prolonged uterine bleeding, or to determine whether cancer is present in the endometrial lining of the uterus. A biopsy may also be performed to determine whether the endometrium is consistently undergoing the typical series of changes which occurs during a menstrual cycle.

Before undergoing an endometrial biopsy, a woman should ensure that her doctor has access to all relevant health information. This includes whether or not she is pregnant, or might be pregnant; this procedure cannot be carried out on a pregnant woman as it may endanger the fetus. She must also tell her doctor if she is taking any medication, including over-the-counter preparations, or is allergic to any medication. Finally, she must tell her doctor if she has recently experienced any pelvic, cervical, or vaginal infections, or has ever been treated for such infections in the past.

The endometrial biopsy procedure takes only around fifteen minutes, and is usually carried out by a gynecologist, general physician, or certified nurse practitioner. At the beginning of the procedure, a spray solution of local anesthetic may be used to numb the cervix. Next, a speculum is inserted into the vagina to expand the vagina and allow the doctor to access the cervix. Following this a biopsy tool is inserted through the cervix into the uterus, so that a sample of endometrium can be obtained.

During the biopsy it is common for a woman to feel pain similar to menstrual cramping. Some cramping may also be experienced for several hours following the procedure, but the pain should not be worse than that of a typical period. Many women will experience light vaginal bleeding after the biopsy, which may persist for several days. A woman should call her doctor for advice if pain or bleeding worsens beyond that of a normal period, if a fever develops, or if vaginal discharge smells unpleasant, as these symptoms may indicate an infection.

Endometrial biopsy results are developed in a pathology laboratory, where the endometrium sample is examined under a microscope. This examination will determine whether the endometrial lining has undergone any changes that might indicate cancer or another disease. An abnormal result may indicate the presence of cancer or a benign growth, or a disease such as endometrial hyperplasia, in which the endometrium becomes overgrown. In some cases the results may be inconclusive, which may prompt another biopsy or other tests.