What is an endometrial biopsy?

An endometrial biopsy is a way for your doctor to take a small sample of the lining of the uterus. The sample is looked at under a microscope for abnormal cells. An endometrial biopsy helps your doctor find problems in the endometrium. It also lets your doctor check to see if your body’s hormone levels that affect the endometrium are in balance.

There are several ways to do an endometrial biopsy. Your doctor may use:

• A soft device shaped like a straw (pipette) to suction a small sample of lining from the uterus. This method is fast and may cause some cramping.
• An electronic suction device (Vabra aspiration). This method can be uncomfortable.
• A spray of liquid (jet irrigation) to wash off some of the tissue that lines the uterus. A brush may be used to remove some of the lining before the washing is done.

An endometrial biopsy may be done to find the cause of abnormal uterine bleeding, to check for overgrowth of the lining (endometrial hyperplasia), or to check for cancer.

When a woman is having a hard time getting pregnant, an endometrial biopsy may also be done to see whether the lining of her uterus can support a pregnancy.

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 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.
• Have had bleeding problems or take blood-thinners, such as aspirin or warfarin.
• 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.

How It Is Done

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.