How effective is endometrial biopsy for endometrial hyperplasia?

Hyperplasia means the lining of the womb has become thicker or has developed an unusual pattern of cells. A biopsy collects lining tissue so a laboratory can look for overgrowth and for atypical cells, which can change the treatment discussion. The result is based on the tissue collected, so a small or uneven area may not be represented. A polyp or other focal lesion can also be missed. Depending on bleeding, ultrasound findings and the pathology report, a clinician may recommend hysteroscopy, another sample or monitoring.

Share your bleeding history, medicines, pregnancy possibility and any hormonal treatment with the clinician. Ask when the pathology result will be reviewed and whether treatment such as progesterone, removal of a focal lesion or further investigation is advised. Keep follow-up appointments, because symptoms and lining changes may need review even when the first sample does not show atypia. Do not start or stop hormones without clinical advice.

After biopsy, seek advice for increasing cramps, heavy bleeding, fever, foul-smelling discharge or difficulty passing urine. Urgent assessment is appropriate for severe pelvic pain, fainting or bleeding with marked weakness. Arrange a clinical review for new, persistent or recurrent abnormal bleeding, including bleeding after menopause, because the symptom needs assessment regardless of the biopsy result.

Ask whether the sample was adequate, whether atypical cells were found, whether a focal lesion could have been missed, what treatment is recommended, and when the lining should be checked again.