What Is an Endometrial Biopsy?
An endometrial biopsy is a medical procedure in which a small sample of the lining of the uterus (called the endometrium) is gently taken and checked in a laboratory. The endometrium is the tissue that builds up each month during the menstrual cycle and sheds during menstruation. In some cases, this lining may need to be examined to find the cause of abnormal bleeding, infertility issues, or other uterine concerns.
By looking at the cells under a microscope, doctors can determine if there are infections, inflammation, abnormal changes, or early signs of cancer. The procedure is quick, usually done in a clinic or hospital, and is an important tool to help diagnose many conditions related to the uterus.
Purpose & Benefits of an Endometrial Biopsy
● Checks for abnormal endometrial cells
● Helps find the cause of irregular bleeding
● Evaluates the uterine lining in fertility assessment
● Detects infection or inflammation
● Rules out endometrial hyperplasia or early cancer
● Guides treatment for menstrual or uterine problems
Who May Need an Endometrial Biopsy?
An endometrial biopsy may be recommended if you have:
● Abnormal uterine bleeding (heavy, frequent, or between periods)
● Postmenopausal bleeding
● Difficulty becoming pregnant (infertility evaluation)
● Thickened uterine lining seen on ultrasound
● History of uterine polyps or abnormalities
● Suspicion of endometrial disease
Your doctor will discuss why the biopsy is needed and what results may help decide treatment.
Types of Endometrial Biopsy
There are a few ways to take an endometrial sample:
1. Office Endometrial Biopsy
This is the most common method. It can be done in a doctor’s clinic using a small suction tool to collect tissue from the uterus.
2. Hysteroscopy-Guided Biopsy
A small camera (hysteroscope) is inserted through the cervix to view the uterus while the biopsy is taken, which is useful if the doctor wants direct visualization.
3. Dilatation & Curettage (D&C)
In some cases, this surgical method is used to collect a larger sample, especially if the initial biopsy was incomplete or unclear.
Each method allows doctors to examine the tissue and make accurate diagnoses.
Endometrial Biopsy Procedure: Step-by-Step
1. Preparation & Examination
Your doctor reviews your medical history and symptoms.
A pelvic exam may be done before the biopsy.
2. Positioning
You lie on the exam table with your feet in supports (like a pelvic exam).
3. Cervical Cleaning & Mild Pain Relief
The cervix is cleaned with antiseptic.
A local numbing medicine may be given so you feel minimal discomfort.
4. Inserting the Tool
A small tube-like instrument is gently placed through the cervix into the uterus.
5. Collecting the Sample
A tiny suction or scraping tool takes a small sample of the endometrial lining.
You may feel cramping or mild pressure for a short time.
6. Finishing Up
The instrument is removed, and you are observed briefly.
The tissue sample is sent to the lab for analysis.
Most biopsies take about 5–10 minutes, and you can usually go home the same day.
Recovery & Aftercare
After the biopsy:
● You may have mild cramps or discomfort for a few hours; this is normal.
● Light spotting or bleeding is common for a day or two.
● Avoid inserting anything into the vagina (tampons or sex) for about 24–48 hours or as advised.
● Take pain relief medicine if your doctor recommends it.
● Resume normal activities unless told otherwise by your doctor.
Follow-up depends on your biopsy results and your doctor’s advice for treatment.
Risks & Possible Side Effects
An endometrial biopsy is generally safe, but some side effects can occur:
● Mild cramping or pain
● Light bleeding or spotting
● Infection (rare)
● Dizziness during or after the procedure
● Spotting for a few days
Report heavy bleeding, fever, severe pain, or foul-smelling discharge to your doctor immediately.
Endometrial Biopsy vs Pap Smear
Endometrial Biopsy
● Samples the uterine lining
● Used to evaluate bleeding or uterine problems
● Checks for abnormal cells inside the uterus
Pap Smear
● Samples cells from the cervix
● Used to detect cervical cancer or precancerous changes
● Does not sample the uterine lining
Both are important gynaecologic tests but serve very different purposes.
Obstetricians and Gynecologists
Gynecology
