Endometrial Biopsy

An endometrial biopsy is a medical procedure used to collect a sample of tissue from the lining of the uterus, known as the endometrium. The sample is then examined under a microscope for abnormal cell growth, cancer, or other conditions.

Purpose

The purpose of an endometrial biopsy is to:

• Diagnose abnormal uterine bleeding, such as heavy or irregular menstrual periods
• Investigate the cause of infertility or recurrent miscarriages
• Check for endometrial cancer or precancerous conditions
• Monitor the effectiveness of hormone replacement therapy (HRT)
• Evaluate the uterine lining in women with polycystic ovary syndrome (PCOS) or other hormonal imbalances

Types of Endometrial Biopsy

There are two main types of endometrial biopsy:

• Office endometrial biopsy: This is a simple procedure that can be performed in a doctor's office. A thin, flexible tube called a catheter is inserted through the cervix and into the uterus to collect a sample of tissue.
• Dilation and curettage (D&C) biopsy: This is a more invasive procedure that requires anesthesia and is typically performed in a hospital or surgical center. The cervix is dilated, and a special instrument called a curette is used to scrape away tissue from the uterine lining.

Preparation

To prepare for an endometrial biopsy:

• Avoid taking aspirin or other blood-thinning medications for at least 7-10 days before the procedure
• Stop taking any hormone replacement therapy (HRT) or birth control pills for at least 1-2 weeks before the procedure
• Have a full bladder to help the doctor visualize the uterus during the procedure
• Wear comfortable clothing and avoid wearing perfume, lotion, or powder on the day of the procedure

Procedure

The endometrial biopsy procedure typically involves:

• Lying on an exam table with your feet in stirrups
• A speculum being inserted into the vagina to hold it open
• A local anesthetic being applied to the cervix to numb the area
• The catheter or curette being inserted through the cervix and into the uterus
• A sample of tissue being collected from the uterine lining
• The procedure typically taking 5-10 minutes to complete

Risks and Complications

As with any medical procedure, there are risks and complications associated with an endometrial biopsy, including:

• Bleeding or spotting after the procedure
• Cervical stenosis (narrowing of the cervix)
• Infection
• Uterine perforation (a hole in the uterus)
• Adverse reaction to anesthesia

Results

The results of an endometrial biopsy are typically available within 1-2 weeks. The sample is examined under a microscope for:

• Abnormal cell growth or cancer
• Infection or inflammation
• Hormonal imbalances
• Other conditions, such as endometrial hyperplasia or polyps

Follow-up Care

After an endometrial biopsy:

• Avoid heavy lifting, bending, or strenuous activity for at least 24 hours
• Take pain medication as directed by your doctor to manage any discomfort or cramping
• Use sanitary pads or tampons to absorb any bleeding or spotting
• Follow up with your doctor to discuss the results and any further treatment or testing that may be needed

Frequently Asked Questions (FAQs)

What is an Endometrial biopsy?
A procedure to remove tissue from the lining of the uterus for examination.

Why is an Endometrial biopsy performed?
To check for abnormal cell changes or cancer, and to investigate abnormal uterine bleeding.

How is an Endometrial biopsy typically done?
Using a thin tube inserted through the cervix into the uterus, often with local anesthesia.

Is an Endometrial biopsy painful?
It can cause mild to moderate discomfort, cramping, or pain, varying from person to person.

What are the risks of an Endometrial biopsy?
Infection, bleeding, and uterine perforation are possible, though generally rare complications.

How long does an Endometrial biopsy take?
Usually around 5-15 minutes, depending on the method and individual circumstances.

Do I need to prepare for an Endometrial biopsy?
Typically, no special preparation is required, but instructions may vary by healthcare provider.

Can I go back to normal activities after an Endometrial biopsy?
Usually, yes, but it's recommended to rest and avoid strenuous activities for a short period.

When can I expect the results of an Endometrial biopsy?
Results typically take several days to a week or more, depending on the laboratory processing time.

Will I need someone to drive me home after an Endometrial biopsy?
It depends on the use of anesthesia or sedation; if used, having someone drive you home is often recommended.