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Dear Doctor: Worried about my upcoming endometrial biopsy

During my recent annual exam at my OB/GYN they asked me to come back for an “endometrial biopsy.” I have always had normal results and was never asked to return for any sort of follow-up appointment, and I am worried. What is an endometrial biopsy? Why do I need to have one? How do I prepare? Will it hurt? I don’t know what a biopsy is. I am worried–why are they asking me to come back? What happens during an endometrial biopsy? Will it hurt? 

Signed,

Worried and Confused

I am glad you went for your annual well-woman exam; it is an integral part of your overall health and can help us catch any issues before they become serious problems. Do not panic about your upcoming endometrial biopsy; it is a minimally invasive procedure that allows your healthcare provider to obtain samples of the cells that make up the endometrium, the tissue that forms the uterus lining.

There are a few reasons your healthcare provider ordered an endometrial biopsy:

  • Abnormal uterine bleeding: If you have unusual patterns of bleeding, such as continuous spotting in between periods or for post-menopausal women, if you continue to bleed at all
  • Risk of endometrial cancer: We usually do not screen for endometrial cancer, but for high-risk patients, a biopsy can help confirm whether or not any sort of growth is present
  • Fertility screening: Inspect the health of the uterine or check if you have endometriosis 

You don’t have to do anything special to prepare for an endometrial biopsy–if you think you may be in pain during the procedure, you can take an over-the-counter pain reliever 30-60 minutes prior to help with any discomfort.

During the procedure, you will be asked to remove your clothing from the waist down. Much like a pap smear, you’ll lay on the examination table with your feet in stirrups. Depending on your preference and what is offered, your healthcare provider may use a numbing cream before inserting a thin, flexible tube called a pipelle through the opening of your cervix and several inches into your uterus. The small tool gathers a uterine tissue sample before they promptly remove it. The entire procedure usually takes less than ten minutes. 

You may feel some discomfort and light spotting or bleeding after the procedure, and cramping isn’t uncommon. If you are in intense pain, please let your healthcare provider know. Your healthcare provider may also recommend that you abstain from sexual intercourse or using tampons for a few days after the procedure. 

The office will send the tissue sample to a lab for examination, and you’ll have your results within a few days. In many cases, the results are normal, but if they are not, your healthcare provider will discuss the results and next steps with you.

Do not be worried; endometrial biopsies are safe, minimally invasive procedures that just help us better examine and understand any changes to your uterus. You’ll be in and out of the office in less than 30 minutes.

If you have further questions, contact your Genesis OB/GYN provider and request an appointment today.

Best,

Dr. Christopher Sullivan

Christopher Sullivan, MD, FACOG is a board-certified gynecologist practicing at Genesis OB/GYN in Tucson, AZ.