Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. 

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Am Fam Physician. 2020;101(9):online

Related article: Endometrial Biopsy: Tips and Pitfalls

What is endometrial biopsy?

Endometrial biopsy is a safe and effective way to evaluate the tissue that lines the inside of the uterus (or womb). A thin plastic tube called a catheter is placed into the uterus, and a small amount of the lining is suctioned into the device. This method provides a tissue sample as good as or better than the older dilatation and curettage (D&C) procedure.

Why is endometrial biopsy performed?

It is done to check the uterine lining for cancer or precancerous cells. Most women who have this procedure have abnormal uterine bleeding or bleeding after menopause. Women at higher risk of endometrial cancer, such as those who have hereditary nonpolyposis colorectal cancer (also known as Lynch syndrome), should have regular endometrial biopsies. This procedure is no longer a routine part of infertility testing.

Is endometrial biopsy painful?

It can be uncomfortable. Placing the catheter inside the uterus can cause cramping. To decrease cramping, you can take medicines such as ibuprofen (one brand: Motrin) or naproxen (one brand: Alleve) 30 to 60 minutes before the procedure. Your doctor can also apply a numbing medicine. The procedure takes just a few minutes. Most women tolerate it well.

What problems may develop after endometrial biopsy?

You may have vaginal bleeding for a few days. You should not have an endometrial biopsy if you are pregnant. Be sure to tell your doctor if you might be pregnant because the procedure can hurt your baby. In rare cases, women may get an infection in the uterus or fallopian tubes or the catheter could make a hole in the wall of the uterus. If you have fever, persistent cramping, belly pain, or bleeding heavier than a normal period after 24 hours, tell your doctor.

What happens to the sample taken from the lining of my uterus?

The sample is sent to a specialist called a pathologist. He or she will examine cells from the tissue under a microscope and can tell if your cells show cancer or precancer. Your doctor's office will contact you with the tissue exam results.

Following Endometrial Biopsy

  • If you have pain or discomfort after the procedure, you may take ibuprofen, naproxen, or acetaminophen (one brand: Tylenol).

  • You may drive home after the procedure, unless your doctor gave you extra medicines in the office to complete your procedure.

  • Some vaginal bleeding or spotting is common after the biopsy. If you have heavy bleeding, call your doctor.

  • Infection after the biopsy is uncommon, but call your doctor if you have pain in your lower belly or vagina, or a bad-smelling vaginal discharge.

Where can I find more information?

Your doctor

National Cancer Institute

National Institutes of Health

U.S. National Library of Medicine's MedlinePlus

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