Published: Sep 10, 2016, edited: Oct 9, 2017 by Dr. Zelmanovich (Gynecologist in NYC), Manhattan Women's Health & Wellness

Endometrial Biopsy

Endometrial Biopsy ProcedureAn endometrial biopsy refers to the procedure your doctor may perform that involves removing a tiny piece of tissue from your endometrium, more commonly called the uterine lining. The test is done so that the fibrous tissue can be examined under a microscope or more extensively in a lab.

Even a small sample of tissue can help to confirm a diagnosis that may not be apparent on previous tests. The sample may show changes in the cells that indicate a certain condition or reflect hormone changes. After an endometrial biopsy, your doctor typically will have a clearer idea of your condition and which treatment you require — or that additional tests need to be performed.

Why You Might Need the Test

The test can reveal a number of conditions from the tissue sample removed during an endometrial biopsy. But according to Johns Hopkins Medicine, while a biopsy can determine your hormone levels, it’s no longer deemed appropriate to resort to such an invasive test for routine checks of your hormone levels — especially when you’re undergoing infertility treatments.

Conditions that may require that you undergo a biopsy to find a cause of your symptoms include:

  • Bleeding that occurs after you’ve stopped menstruating due to menopause
  • Discovery of a thickened uterine wall following an ultrasound
  • Excessive bleeding while taking fertility drugs
  • Menstrual periods that include an abnormally strong blood flow, such as bleeding that lasts too long, is heavier than normal or is continuously irregular
  • Check for endometrial cancer

The test may be indicated if your OBGYN believes you may have an infection that can’t otherwise be confirmed. Infections very often lead to excessive bleeding, a condition called endometriosis. Testing for endometrial cancer is a vital step in the treatment of the disease because this type of cancer is the most common form that occurs in the female reproductive system. At the same time, your doctor may have other reasons for conducting an endometrial biopsy.

What You Can Expect

Endometrial biopsy steps usually are performed on an outpatient basis in the doctor’s office. It can, however, be done while you’re hospitalized for symptoms that have become more serious. The place where the test takes place depends on your overall health and condition.

The usual process that you’ll follow involves the following steps:

  • You empty your bladder before the procedure begins.
  • You remove your clothes from the waist down.
  • You lie on an examination table with your feet in stirrups, like you do when you’re getting your annual pelvic exam.
  • Your doctor inserts into your vagina the speculum that you’re likely familiar with from previous gynecological exams. It’s used to spread the walls of your vagina for better viewing.
  • Your OBGYN cleans the internal area with antiseptic.
  • Then you doctor applies either a numbing spray or giving you a very small injection of local anesthetic medication.
  • Forceps may be inserted to hold your cervix open during the rest of the biopsy.
  • Additionally, a uterine sound — a long, thin instrument — may be inserted to measure the length of your uterus to find the best place to take the tissue sample. The sound is removed immediately after finding the appropriate location.
  • A catheter, or thin tube, is inserted, through which a smaller tube is then passed. The inner tube uses suction to gather a tissue sample as your doctor rolls it around inside your uterus.
  • The instruments are removed and the sample preserved in a solution prepared to be sent to the laboratory.

The amount of tissue taken depends on your symptoms and what your doctor suspects may be going on. The test is relatively painless, although you may feel some discomfort when your cervix is spread. The instruments may be cold to the touch, which can cause cramping while they’re inserted and rotated in your uterus. The entire procedure shouldn’t last longer than about 30 minutes.

When considering an endometrial biopsy vs colposcopy, remember that the colposcopy is often the first procedure performed because that test just involves looking at your cervix when it’s set up and spread. If your doctor sees abnormalities, he then can proceed with the biopsy without putting you through additional procedures.

Following the Test

If you were put under any kind of relaxing sedation for the test, you’ll need to have someone drive you home from the office. After a short rest, you may need to wear a sanitary pad to trap any residual small amount of bleeding that’s common after uterine biopsies.

It’s also common that you may continue to feel some discomfort and cramping for a few days; your doctor may give you a mild pain reliever if you need it. Follow directions closely because some over-the-counter pain relievers, such as aspirin and ibuprofen, can cause additional bleeding.

To prevent adverse consequences from the procedure:

  • Refrain from sex after endometrial biopsy for two to three days.
  • Avoid douching or using tampons for two to three days or for the time recommended by your physician.
  • Resume your normal diet and eating patterns unless otherwise directed.
  • Limit your activity for a couple days. At least avoid heaving lifting or strenuous exercise during this time or for as long as your doctor advises.
  • Return for a follow-up visit as directed.

Potential Side Effects

While the endometrial biopsy is generally safe with little or no long-term side effects, there always are potential issues that can arise with any procedure. Possible risks associated with a uterine biopsy can include:

  • Prolonged bleeding
  • Infection
  • Continued cramping
  • Tearing or perforating your uterine wall, a very rare occurrence

Call your doctor if other, less common, side effects occur, such as:

  • A foul-smelling discharge
  • Continued bleeding after uterine biopsy past two days
  • Severe abdominal cramping or pain
  • Fever or chills

What It Means

In addition to taking care of the mild side effects that you can expect, waiting for the test results can be the most frustrating part of having an endometrial biopsy. If the test results prove normal, the relief you’ll feel will be worth the discomfort. Abnormal results may indicate the line of treatment or the next round of tests. Some results could be:

  • Infection
  • Uterine fibroids
  • Polyps in your uterus
  • Anovulatory bleeding caused by abnormal hormone levels
  • Other hormone imbalances
  • Hyperplasia or pre-cancer
  • Endometrial cancer


Important Reminder: This information is only intended to provide guidance, not a definitive medical advice. Please consult ob/gyn doctor about your specific condition. Only a trained, experienced board certified gynecologist can determine an accurate diagnosis and proper treatment.

Do you have questions about Endometrial Biopsy procedure? Would like to schedule an appointment with a nationally recognized NYC GYN doctor, Dr. Anat Zelmanovich of Manhattan Women’s Health and Wellness, please contact our office for OBGYN consultation.consultation.

Manhattan Women’s Health & Wellness
Dr. Anat Zelmanovich, Gynecologist (Gynecologist NYC, Midtown OB/GYN)
51 East 25th Street, Ste 403
New York, NY 10010
(Between Madison Ave & Park Ave)
(212) 533-4575
Manhattan Women’s Health & Wellness
Dr. Anat Zelmanovich, Gynecologist (Gynecologist NYC, Upper East Side OB/GYN)
983 Park Ave, Ste 1D
New York, NY 10028
(Between 83th & 84th Street)
(212) 533-4575
The information on this website is to provide general guidance. In no way does any of the information provided reflect definitive medical advice and self diagnoses should not be made based on information obtained online. It is important to consult a best in class gynecologist in Midtown regarding ANY and ALL symptoms or signs as it may a sign of a serious illness or condition. A thorough consultation and examination should ALWAYS be performed for an accurate diagnosis and treatment plan. Be sure to call a physician or our Gynecology NYC office today and schedule a consultation with a top Midtown OBGYN gynecologist.