Endometrial Biopsy

Endometrial Biopsy

Why Would You be Doing an Endometrial Biopsy?

An endometrial biopsy is typically done when your doctor suspects you have a problem with your endometrium. Such problems can include endometrial hyperplasia, low estrogen or progesterone, and endometrial cancer. Blood tests are a more common (and less painful) way of detecting progesterone and estrogen problems. Endometrial hyperplasia and cancer are very rare in women under 40. Nonetheless, if you have problems with LP spotting and your progesterone levels are normal, an endometrial biopsy might be a good idea.

What You Can Expect

The biopsy is an outpatient procedure that only takes 10-15 minutes to complete. Before the biopsy you should take something for the pain, since the procedure isn’t performed under sedation.You can take painkillers prescribed by the doctor looking after you. The first stage of the biopsy is very similar to a normal PAP smear. After you get comfortable in the stirrups, your doctor will insert a speculum. If your cervix isn’t at the right angle, your doctor will need to use a tenaculum to move it into position. This does hurt, because the tenaculum has pincers that grip your cervix and usually cause some bleeding. After that, your doctor will dilate your cervix and insert a Pipelle aspirator, which uses suction to collect the sample. You’ll feel cramping and then a pulling as the aspirator gathers its sample. If you’ve had an HSG, this part of the biopsy will feel very familiar.

After the doctor has collected a large enough sample, he/she will remove the instruments, and you’re done! If the doctor needed to use a tenaculum, they will probably use some silver nitrate to stop the bleeding on your cervix.

Post-biopsy, you may have some cramping and tenderness, and your doctor will probably recommend that you take more pain medication that night. A Lot of women experience very little to no pain. You’ll probably experience some spotting, possibly as heavy as a period. If you start bleeding more than that, or the bleeding lasts longer than a day or two, call your doctor.

Lab results should be available within a week. Before you leave, ask your doctor when you can schedule a follow-up appointment to discuss them.

Problems That Might Arise

  • Bleeding
  • Pelvic infection
  • Puncture of the uterine wall with the biopsy device, which is rare


After the procedure, you may rest for a few minutes before going home. If you had any type of sedative, you will need someone to drive you home.

You may want to wear a sanitary pad for bleeding. It is normal to have some mild cramping and spotting or vaginal bleeding for a few days after the procedure. Take a pain reliever as advised by your healthcare provider. Aspirin or certain other pain medicines may increase the chance of bleeding. Be sure to take only recommended medicines.

Don’t douche, use tampons, or have sex for 2 to 3 days after an endometrial biopsy, or for a time recommended by your healthcare provider.

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