Test Overview
An endometrial
biopsy is a way for your doctor to take a small sample
of the lining of the uterus (endometrium). The sample is looked at
under a microscope for abnormal cells. An endometrial biopsy helps your doctor
find problems in the endometrium. It also lets your doctor check to see if
your body's hormone levels that affect the endometrium are in balance.
There are several ways to do an endometrial biopsy. Your doctor may
use:
- A device shaped like a straw (pipette) to suction
a small sample of lining from the uterus. This method is fast and may cause some cramping.
- An
electronic suction device (Vabra aspiration). This method can be uncomfortable.
- A spray of liquid (jet irrigation) to wash off some of the tissue
that lines the uterus. A brush may be used to remove some of the lining before
the washing is done.
An endometrial biopsy may be done to find the cause of
abnormal uterine bleeding, to check for overgrowth of the lining (endometrial
hyperplasia), or to check for cancer.
When a woman is having a hard time getting pregnant, an
endometrial biopsy may also be done to see whether the lining of her uterus can
support a pregnancy.
An endometrial biopsy is sometimes done at the same time as another
test, called
hysteroscopy, which allows your doctor to look through
a small lighted tube at the lining of the uterus.
Why It Is Done
An endometrial biopsy is done to:
- Check for cancer of the uterus.
- Find the cause of heavy, prolonged, or irregular uterine
bleeding. It is often done to find the cause of uterine bleeding in women who
have gone through
menopause.
- See whether the lining of the
uterus (endometrium) is going through the normal menstrual
cycle changes.
How To Prepare
Tell your doctor if you:
- Are or might be pregnant. An endometrial biopsy
is not done during pregnancy.
- Are taking any
medicines.
- Are allergic to any medicines.
- Take a blood thinner, or if you have had bleeding problems.
- Have been treated for a vaginal, cervical, or pelvic
infection.
- Have any heart or lung problems.
Do not douche, use tampons, or use vaginal medicines for 24 hours
before the biopsy. You will empty your bladder just before your biopsy.
You may want to take a pain reliever, such as ibuprofen (Advil or
Motrin), 30 to 60 minutes before having the biopsy. This can help decrease any
cramping pain that can be caused by the biopsy.
You will be asked to sign a consent form that says you understand the risks of the test and agree to have it done.
Talk to your
doctor about any concerns you have regarding the need for the test, its risks,
how it will be done, or what the results may mean. To help you understand the
importance of this test, fill out the
medical test information form(What is a PDF document?).
How It Is Done
Endometrial biopsy
An endometrial biopsy is usually done by a
gynecologist, a
family medicine physician, or a
nurse practitioner who has been trained to do the
test. The sample will be looked at by a
pathologist. The biopsy can be done in your doctor's
office.
You will need to take off your clothes below the waist. You will
be given a covering to drape around your waist. You will then lie on your back
on an examination table with your feet raised and supported by foot rests
(stirrups).
Your doctor will insert a lubricated tool called a speculum into your vagina. The speculum gently spreads apart the vaginal
walls so your doctor can see inside the vagina and the cervix. The cervix is washed with a special
solution and may be grasped and held in place with a clamp called a tenaculum.
Your cervix may be numbed with a spray or injection of
local anesthetic.
The tool to collect the sample is guided through the cervix into
the
uterus. The tool may be moved up and down to collect
the sample. Most women have some cramping during the biopsy.
An endometrial biopsy takes 5 to 15 minutes.
How It Feels
Endometrial biopsy
You may feel a sharp
cramp as the tool is guided through your cervix. You may feel more cramping
when the biopsy sample is collected. Most women find that the cramping feels
like a really bad menstrual cramp.
Some women feel dizzy and sick to their stomachs. This is called
a
vasovagal reaction. This feeling will go away after
the biopsy.
An endometrial biopsy usually causes some vaginal bleeding. You
can use a pad for the bleeding or spotting.
Risks
There is a small chance that the cervix or uterus could be
punctured during the biopsy. Bleeding or a pelvic infection is also
possible.
After the test
You may feel some soreness in your vagina for a day or two. Some
vaginal bleeding or discharge is normal for up to a week after a biopsy. You
can use a sanitary pad for the bleeding. Do not do strenuous exercise or heavy
lifting for one day after your biopsy. Do not have sex, use tampons, or douche until the spotting stops.
Follow any instructions your doctor gave you. Call your doctor if
you have:
- Heavy vaginal bleeding (more than a normal
menstrual period).
- A fever.
- Belly
pain.
- Bad-smelling vaginal discharge.
Results
An endometrial biopsy is a way for your doctor to take a small
sample of the lining of the uterus (endometrium). Lab results from a biopsy
may take several days to get back.
Endometrial biopsy| Normal: | No abnormal cells or cancer is found. For women who have
menstrual cycles, the lining of the uterus is at the right stage for the time
in the
menstrual cycle when the biopsy was done. |
|---|
|
Abnormal: | A noncancerous (benign) growth, called a
polyp, is present. |
|---|
Overgrowth of the lining of the uterus (endometrial
hyperplasia) is present. |
Cancer or cell changes that may lead to cancer are present. |
For women who have menstrual cycles, the lining of the
uterus is not at the right stage for the time in the menstrual cycle when the
biopsy was done. More tests may be needed. |
What Affects the Test
Reasons you may not be able to have the endometrial biopsy or why
the results may not be helpful include:
- If you are pregnant. An endometrial biopsy is not done during
pregnancy.
- If a vaginal or cervical infection is present.
The infection could spread to the uterus if an endometrial biopsy is
done.
- If the endometrial biopsy sample is not large enough to see
abnormal cells. Another test may be needed.
What To Think About
- An endometrial biopsy is not done during
pregnancy.
- More of the uterine lining can be sampled during a
dilation and curettage (D&C) than during an endometrial biopsy. Another
test, called a
hysteroscopy, is usually done with a D&C so that
your doctor can see the lining of your uterus. A hysteroscopy may also be done
instead of a D&C. To learn more, see the topic
Hysteroscopy.
- An endometrial biopsy is not
usually done during or after
menopause unless a woman has abnormal vaginal
bleeding.
References
Other Works Consulted
- Pagana KD, Pagana TJ (2010). Mosby's Manual of Diagnostic and Laboratory Tests, 4th ed. St. Louis: Mosby.
Credits
ByHealthwise Staff
Primary Medical ReviewerSarah Marshall, MD - Family Medicine
Kathleen Romito, MD - Family Medicine
Martin J. Gabica, MD - Family Medicine
E. Gregory Thompson, MD - Internal Medicine
Specialist Medical ReviewerFemi Olatunbosun, MB, FRCSC - Obstetrics and Gynecology
Current as ofOctober 13, 2016