Endometrial Biopsy: What to Expect

An endometrial biopsy, sometimes called a Pipelle biopsy or womb lining biopsy, removes a small sample of tissue from inside the uterus. A laboratory examines the sample for changes such as thickening, inflammation, or abnormal cells. The procedure is usually done during an outpatient visit and does not require an incision through the abdomen.

An endometrial biopsy removes a small sample from the womb lining so a laboratory can examine it for abnormal changes.

You lie back for an examination. A clinician places a speculum to see the cervix, cleans the area, and guides a slender flexible tube through the cervix into the uterus. Gentle suction collects tissue. You may feel cramping as the sample is taken; tell the clinician if the discomfort is difficult to manage.

Endometrial biopsy is commonly used to investigate the womb lining, but no sample gives a perfect view of every area. The result is more useful when combined with your bleeding pattern, examination, and scans. Infection, heavier bleeding, or a small injury to the uterus can occur, although these are uncommon. The clinician can explain whether the sample was adequate.

An abnormal result does not by itself determine the next step. It may show benign thickening, hyperplasia, inflammation, or cancerous cells. Your clinician may recommend another sample, a camera examination of the uterus, imaging, medicine, or surgery depending on the finding and your plans for pregnancy. Womb cancer and endometrial hyperplasia are examples of conditions the test can help investigate.

The biopsy checks the endometrium, the tissue that lines the inside of the uterus. It is different from a cervical screening test, which examines cells from the cervix. Bring a list of medicines and mention blood thinners, allergies, or a possible pregnancy before the appointment.

A clinician may suggest this test for bleeding between periods, unusually heavy bleeding, bleeding after menopause, or a womb lining that looks thickened on imaging. It may also be considered when symptoms continue or when treatment has not explained the bleeding. The decision depends on age, menstrual or menopause status, medicines, examination findings, and pregnancy plans.

Before the visit, ask whether you should take usual medicines and whether pain relief is suitable for you. At the appointment, share the first day of your last period and any chance of pregnancy. After consent, the clinician takes the sample, labels it, and sends it for examination. The appointment may be brief, but allow time afterwards if you develop cramps.

Mild period-like cramps and light spotting can occur after the biopsy. Use the sanitary protection recommended by your clinic and follow its advice about bathing, sex, and tampons. Contact a healthcare professional promptly for heavy bleeding, fever, worsening pelvic pain, dizziness, or discharge with an unpleasant smell.

Temporary cramping is common. Less common problems include infection, bleeding that is heavier than expected, fainting, or difficulty obtaining enough tissue. Tell the clinic if you may be pregnant, because the procedure may need to be postponed. Seek urgent care for severe pain, fainting, or bleeding that makes you feel unwell.

Depending on the question, alternatives may include an ultrasound, hysteroscopy, or monitoring. A hysteroscopy uses a small camera to look inside the uterus and can sometimes guide a targeted sample or treatment. If a serious abnormality is confirmed, treatment may include medicine or hysterectomy; the choice depends on the diagnosis and your priorities.

A gynaecologist or trained clinician can assess abnormal uterine bleeding and arrange an endometrial biopsy when appropriate. Ask where the sample will be examined, when results are expected, and who will explain them. Take your symptoms, medicines, and previous scan reports to the appointment.