When Is Endometrial Biopsy Recommended for Endometrial Hyperplasia?

Endometrial hyperplasia is an overgrowth of the lining of the womb. An ultrasound can show that the lining looks thickened, but it cannot reliably show whether the cells are harmless, atypical, or cancerous. A biopsy removes a small sample of lining so a laboratory specialist can examine the cells. Sampling is commonly considered when abnormal or heavy bleeding continues, when bleeding occurs after menopause, or when imaging and the person’s symptoms need further assessment. It may also be advised after hyperplasia has been found, because the tissue result helps determine treatment and follow-up.

The result may describe hyperplasia without atypia or atypical hyperplasia. Atypical changes need particular attention because they can occur alongside, or raise concern for, endometrial cancer. A biopsy recommendation does not by itself mean that cancer is present.

Arrange the recommended appointment and tell the clinician about bleeding patterns, menopause status, medicines, hormone treatment, and any chance of pregnancy. Ask whether pain relief is suitable and whether any preparation is needed. During the appointment, the clinician usually explains the procedure, takes consent, and passes a narrow instrument through the cervix to collect the sample. Cramping and light bleeding can occur afterwards; follow the care instructions you are given and report symptoms that concern you.

If the sample is too small or does not explain the symptoms, further assessment may be needed. This can include another sampling procedure or a camera examination of the womb, depending on the findings.

Contact a healthcare professional promptly for bleeding after menopause, bleeding that is unusually heavy or persistent, or bleeding between periods. After a biopsy, seek urgent medical advice for heavy bleeding, severe or worsening pain, fever, faintness, or unpleasant-smelling discharge. These symptoms can need assessment for infection or another complication.

Ask what prompted the biopsy, what the ultrasound or examination showed, and what the result could change about treatment. You can also ask when and how results will be shared, what symptoms should prompt a call, and whether a specialist review is appropriate.