Do you need hysterectomy after endometrial biopsy?

An endometrial biopsy samples the lining of the womb. It may show normal tissue, a benign change, hormonal effects, a precancerous change or cancer. Some results need observation or medicine, while others need further assessment before treatment is chosen. A sample can also be insufficient, so your clinician may suggest another test rather than surgery.

Hysterectomy removes the womb and is a major decision. It may be discussed when cancer or a high-risk precancerous change is confirmed, or when persistent bleeding and other conditions have not improved with suitable alternatives. The operation means you cannot carry a future pregnancy, so fertility plans belong in the discussion.

Ask for the exact wording of the pathology report and whether the sample was adequate. Your clinician may combine it with bleeding history, examination, ultrasound or hysteroscopy findings. Discuss medicines, repeat sampling and other procedures where they fit your diagnosis. If cancer is found or suspected, ask whether a gynaecology oncology team should review the plan.

Contact your care team promptly for heavy or worsening bleeding, severe pelvic pain, fever, faintness, or unpleasant-smelling discharge after the biopsy. Seek urgent help if bleeding makes you feel weak or dizzy, or if pain is severe and does not settle.

Ask: What exactly did the biopsy show? Was the sample adequate? Do I need another test? What options protect my fertility? If hysterectomy is advised, what is the reason, what would it involve and are there alternatives?