Endometrial Biopsy 101: Everything you need to know

Sometimes, your healthcare provider may need to look more closely at uterine tissue for a definitive diagnosis or help manage certain treatments. In an endometrial biopsy, your provider removes a small piece of tissue from the endometrium, the lining of the uterus, to study and look for abnormal cells or evidence of changes to your uterus. 

It is a relatively straightforward in-office procedure that takes less than 15 minutes and does not require anesthesia. In this post, we discuss everything you need to know about what to expect, how the procedure is performed, what results can mean, etc. 

Why is an endometrial biopsy done?

Your Genesis provider may recommend an endometrial biopsy for several reasons—it does not necessarily mean there is evidence of a life-threatening condition. Often, ObGyns order biopsies for one of the following reasons:

• Abnormal or heavy menstrual bleeding: If you experience heavy, painful, or abnormal periods, it could be a sign of a hormonal condition like endometriosis
• Post-menopausal bleeding: While some breakthrough spotting is expected during and after menopause, regular vaginal bleeding could indicate an issue that requires further investigation.
• Abnormal pelvic or ultrasound exam results: If you’ve had abnormal results from a pelvic exam, Pap smear, or ultrasound, a biopsy is often the next step to gather more information.
• Screening for endometrial cancer: A biopsy is a key tool for detecting endometrial cancer, especially if other symptoms or risk factors are present.
• Treatment monitoring: If you are undergoing hormone therapy, a biopsy can help your ObGyn monitor any changes to your uterus over time.

What to expect during the endometrial biopsy procedure

How to prepare

There isn’t any special preparation you need to do ahead of time–you do not need to shave or use any special soaps or other hygiene products. However, there are some things to consider prior to the procedure:

• If you are pregnant or expect you may be pregnant, you should alert your ObGyn. The biopsy is not safe for pregnancies and may result in a termination of the pregnancy.
• Alert your ObGyn if you are allergic to latex or iodine so they can use a safe alternative.
• Also, alert your ObGyn if you have any sort of bleeding disorder or other complication.
• Endometrial biopsies are not performed under anesthesia, and while they are not considered painful, they can be uncomfortable, so consider taking an over-the-counter pain reliever 60 minutes before the procedure.

What happens during the procedure?

Most endometrial biopsies are performed in-office and take 10 minutes or less. Here is what to expect:

• You’ll be asked to change into a hospital or medical gown and made to lay down on the examination table in stirrups, similar to a pap smear or pelvic exam
• The ObGyn will perform a pelvic exam and clean your vagina and cervix
• The ObGyn inserts a thin, flexible rub called a pipelle through the opening of your cervix and several inches into your uterus.
• The pipelle is gently moved back and forth in the uterus to collect the sample of the uterus lining before being removed. In the rare event that the cervical opening is too narrow or the pipelle cannot pass through for any other reason, your provider may use different tools or methods, but they will discuss that with you before making that decision.
• The collected sample is sent to a laboratory for analysis, with results expected in 7-10 days

Post-procedure and endometrial biopsy recovery

After the procedure, you may experience mild cramping and/or light spotting or bleeding, so wear a pad for the remainder of the day. Do not wear a tampon, douche or have sexual intercourse for several days following the procedure. You should also avoid strenuous exercise or activity, if possible. Always follow the aftercare instructions provided by your ObGyn.

When to expect results and what they mean

Results generally take 7-10 days, and your provider will contact you with them. Waiting for important results can be nerve-wracking, but not all endometrial biopsies point to cancer or another serious condition. Whatever the outcome, your provider will work with you on the next steps that make the most sense for you.

There are two possible results from an endometrial biopsy:

• Normal: No abnormal or cancerous cells found
• Abnormal:
  • There is a benign (non-cancerous) growth, called a polyp, present
  • There are uterine fibroids present
  • Evidence of endometrial hyperplasia, which is thickened or overgrown endometrial tissue
  • Cancerous cells or evidence of cells that may become cancerous were found

Risks associated with the procedure

Endometrial biopsies are relatively safe and minimally invasive, but there are still risks, as with all medical procedures. Some of the major risks include a hole in the uterus or tearing of the cervix, which is very rare. There is also a risk of infection or prolonged bleeding.

If you have any of the following after the procedure, you should go to an emergency room and notify your healthcare provider:

• Vaginal swelling, heavy bleeding, or bleeding more than two days after the procedure
• Severe lower abdomen pain
• Nausea, fever, or chills
• Abnormal vaginal discharge (a change in color, consistency or smell)

Endometrial biopsy FAQ

You may still have questions or concerns about the procedure, which is perfectly normal. Below are common questions patients often ask.

Question	Answer
What does an endometrial biopsy test for?	The cause of abnormal bleeding, such as the presence of polyps or uterine fibroids or a thickened uterine lining. Or endometrial cancer.
How long does an endometrial biopsy take?	Between 10-15 minutes.
Can an endometrial biopsy trigger a period?	No
Who should not have the procedure done?	People who:Are pregnant or expect they may be pregnantHave an active pelvic or vulvovaginal infection Have a family history of uterine cancer or other uterine or pelvic condition If any of the above applies to you, alert your provider immediately.
Are endometrial biopsies painful?	They are not considered painful but may be uncomfortable during and immediately following the procedure. If you are worried, take an OTC pain reliever like ibuprofen 60 minutes before the procedure.

Why Phoenix, AZ women trust Genesis with their health

Endometrial biopsies are often the result of an abnormal Pap smear or pelvic exam during an annual women’s wellness check. Having at least one wellness check with your women’s health provider each year is essential for catching issues early and supporting your overall health and wellness.

If you’re looking for a compassionate, knowledgeable provider, don’t hesitate to contact us to request an appointment today. We believe in empowering patients through education and a collaborative doctor-patient relationship, ensuring you receive the best care, tailored to your individual needs.