Endometrial biopsy

Also known as: Biopsy - endometrium

Definition

Endometrial biopsy is the removal of a small piece of tissue from the lining of the uterus (endometrium) for examination.

How the Test is Performed

This procedure may be done with or without anesthesia. This is medicine that allows you to sleep.

  • You lie on your back with your feet supported by foot rests.
  • Your health care provider gently inserts an instrument (speculum) into the vagina to hold it open so that your cervix can be viewed. The cervix is cleaned with a special liquid. Numbing medicine may be applied to the cervix.
  • The cervix may then be gently grasped with an instrument to hold the uterus steady. Another instrument may be needed to gently stretch the cervical opening if there is tightness.

An instrument is gently passed through the cervix into the uterus to collect the tissue sample.

  • The tissue sample and instruments are removed.
  • The tissue is sent to a lab. There, it is examined under a microscope.
  • If you had anesthesia for the procedure, you are taken to a recovery area. Nurses will make sure you are comfortable. After you wake up and have no problems from the anesthesia and procedure, you are allowed to go home.

How to Prepare for the Test

  • Tell your health care provider about all the medicines you take. These include blood thinners such as warfarin, clopidigrel, and aspirin.
  • You may be asked to have a test to check if you are pregnant.
  • In the two days before the procedure, do not use creams or other medicines in the vagina.
  • Do not douche. (You should never douche. Douching can cause infection of the vagina or uterus.)
  • Ask your health care provider if you should take pain medicine, such as ibuprofen or acetaminophen, just before the procedure.

How the Test will Feel

The instruments may feel cold. You may feel some pain when the cervix is grasped. You may have some cramping as the instruments enter the uterus and the sample is collected.

Why the Test is Performed

The test is done to find the cause of:

  • Abnormal menstrual periods (heavy, prolonged, or irregular bleeding)
  • Bleeding after menopause
  • Bleeding from taking hormone therapy medicines
  • Thickened uterine lining seen on ultrasound

The test is usually done in women over age 35.

This test can also be used to test for endometrial cancer.

Normal Results

The biopsy is normal if the cells in the sample are not abnormal.

What Abnormal Results Mean

Abnormal menstrual periods may be caused by:

  • Uterine fibroids
  • Fingerlike growths in the uterus (uterine polyps)
  • Infection
  • Hormone imbalance
  • Endometrial cancer or precancer (hyperplasia)

Other conditions under which the test may be performed:

  • Abnormal bleeding if a woman is taking the breast cancer medication, tamoxifen
  • Abnormal bleeding due to changes in hormone levels (anovulatory bleeding)

Risks

Risks of endometrial biopsy include:

  • Infection
  • Causing a hole in (perforating) the uterus or tearing the cervix (rarely occurs)
  • Prolonged bleeding
  • Slight spotting and mild cramping for a few days

References

Choby BA. Endometrial biopsy. In: Pfenninger JL, Fowler GC, eds. Pfenninger & Fowler’s Procedures for Primary Care. 3rd ed. Philadelphia, Pa: Elsevier Mosby; 2010:chap 143.

Lentz GM. Endoscopy: hysteroscopy and laparoscopy: indications, contraindications and complications. In Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive Gynecology. 6th ed. Philadelphia, Pa: Elsevier Mosby; 2012:chap 10.

Review date:
July 16, 2014
Reviewed by:
Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.
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