Endometrial biopsy
An endometrial biopsy takes a small sample of the uterine lining to check for hyperplasia or cancer. It is done in an office in a few minutes.
Who needs one
- Anyone with bleeding after menopause and a thickened lining or ongoing bleeding
- People 45 and older with abnormal bleeding
- Younger people with abnormal bleeding and long-term exposure to estrogen without progesterone, such as with obesity or PCOS
- People whose bleeding continues despite treatment
- People at high risk, such as those with Lynch syndrome
What it is like
A speculum is placed, as for a Pap test. A thin, flexible tube passes through the cervix and gently suctions a sample. Most people feel strong cramping for a minute or two. Taking ibuprofen about an hour before can help, if it is safe for you. A pregnancy test is done first when relevant.
Afterward
Light spotting and cramps for a day or two are normal. Results usually take one to two weeks. Your physician will review them with you and explain next steps.
If the biopsy is not enough
Sometimes the sample is too small, or bleeding continues despite a normal result. The next step is hysteroscopy, sometimes with a D&C.
Sources
- American College of Obstetricians and Gynecologists. Practice Bulletin No. 128: Diagnosis of abnormal uterine bleeding in reproductive-aged women. Obstet Gynecol. 2012;120(1):197–206 (reaffirmed).
- American College of Obstetricians and Gynecologists. Committee Opinion No. 734: The role of transvaginal ultrasonography in evaluating the endometrium of women with postmenopausal bleeding. Obstet Gynecol. 2018;131(5):e124–e129.
- American College of Obstetricians and Gynecologists; Society of Gynecologic Oncology. Committee Opinion No. 631: Endometrial intraepithelial neoplasia. Obstet Gynecol. 2015;125(5):1272–1278.