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What is endometrial biopsy procedure?
The uterus (womb) is lined by a special type of tissue known as the endometrium. Endometrial biopsy, or endometrial sampling, is a technique of removing a piece of tissue from the inner lining of the uterus. The sample of tissue is analyzed under a microscope in the laboratory by a pathologist, a doctor with special training in diagnosis of diseases based upon tissue examination.
Is endometrial biopsy painful?
Usually, endometrial biopsy procedures painful, and women who are having the procedure should be notified. There are drugs to stop the pain caused by the biopsy. Endometriosis can have an impact psychologicaly on women with the condition due to severe pain. Moreover, the severe pain caused by endometriosis is compounded negatively by the inability to conceive.
Why is endometrial biopsy done?
An endometrial biopsy is most often performed to help determine the cause of abnormal uterine bleeding. It can also be done to help evaluate the cause of infertility, test for uterine infections, and even monitor the response to certain medications.
Endometrial biopsy has many advantages over the more complicated procedure known as dilation and curettage (D&C), which is a more extensive removal of the uterine lining that requires dilation (stretching) of the cervical opening with special instruments. Unlike D&C, endometrial biopsy may be performed in the doctor's office and typically does not require anesthesia or hospitalization.
Endometrial biopsy cannot be performed during pregnancy, and sometimes may not be recommended when certain other conditions are present, including cancer of the cervix or abnormal narrowing (stenosis) of the cervical opening.
How is endometrial biopsy done?
Endometrial biopsy is most often done in the physician's office, but it can be performed on women in the hospital. The patient lies on the examining table in a position similar to that used for obtaining Pap smears. The doctor uses a speculum to open the vaginal canal and visualize the cervix, the opening to the uterus. During endometrial biopsy the doctor inserts a thin plastic or metal tubular device through the cervix into the uterus to remove a tiny piece of the inner lining tissue.
Usually no anesthesia is required, but taking a nonsteroidal anti-inflammatory medication (NSAID) 30 to 60 minutes prior to the procedure can help reduce cramping and pain. In some cases, a small amount of lidocaine anesthetic is inserted into the uterine cavity to minimize discomfort.
What are the risks of endometrial biopsy?
There are very few risks with endometrial biopsy. The leading risk is pain or cramping, but this typically subsides rapidly following the procedure. Other less common risks are:
- Feeling faint or light-headed
- Rarely, perforation of the uterus
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Kuntz, C, MD, CCFP, FCFPO, et al. Endometrial Biopsy. Can Fam Physician. 2007 Jan; 53(1): 43–44.
Priore, G, MD, MPH. Endometrial sampling procedures. UptoDate. Updated: Oct 2018.
Top Endometrial Biopsy Related Articles
Cancer PreventionCertain behavioral, lifestyle, and environmental factors contribute to cancer. Cancer prevention involves modifying these factors to decrease cancer risk. Tobacco use, alcohol consumption, physical inactivity, inadequate fruit and vegetable intake, and obesity increase the risk of certain cancers. Vaccines, genetic testing, and cancer screening also play a role in cancer prevention.
Dilation and CurettageDilation and curettage (D and C or D & C), is a surgery procedure in which the cervix is expanded (dilated) enough to permit the cervical canal and uterine lining to be scraped with a spoon-shaped instrument call a curette (curettage). Recovery time for D and C is about 2 weeks. Usually, a D & C is performed to determine the cause of abnormal vaginal bleeding. Examples of other reasons include endometiral biopsy and to remove tissue after a misscariage or abortion.
Endometrial AblationEndometrial ablation is a surgical procedure performed to treat abnormal uterine bleeding. Endometrial ablation destroys the lining of the tissues of the uterus. There are several procedures used with endometrial ablation including laser beam, electricity ,freezing, heating, or microwave energy Complications may arise during or after the procedure.
Endometriosis implants are most commonly found on the ovaries, the Fallopian tubes, outer surfaces of the uterus or intestines, and on the surface lining of the pelvic cavity. They also can be found in the vagina, cervix, and bladder. Endometriosis may not produce any symptoms, but when it does the most common symptom is pelvic pain that worsens just prior to menstruation and improves at the end of the menstrual period. Other symptoms of endometriosis include pain during sex, pain with pelvic examinations, cramping or pain during bowel movements or urination, and infertility.
Treatment of endometriosis can be with medication or surgery.
Hysteroscopy is a minimally invasive surgical procedure performed to diagnose and treat women's conditions, for example, abnormal vaginal bleeding, congenital abnormalities of the female genital tract, scarring from previous procedures, and removal of uterine fibroids or tumors.
Hysteroscopy may be recommended for evaluating a number of gynecological problems, including scarring, or adhesions, from previous uterine surgery or instrumentation such as dilation and curettage (D&C).
InfertilityInfertility is the diminished ability to conceive a child. Infertility can be a problem with both men and women. Infertility in men can be caused by medical conditions, unhealthy habits, and toxins from the environment. Infertility in women can be caused by problems with ovarian function, the Fallopian tubes, or the physical characteristics of the uterus. Methods of conceiving for couples that cannot conceive include intrauterine inseminations (IUIs) or in vitro fertilization (IVF), specific drugs, assisted reproductive technology (ART), surgery, and gestational carrier.
Infertility QuizWhat is the medical definition of infertility? Take the Infertility Quiz to learn the risks and treatment of infertility. Our answers may surprise you!
Infertility TreatmentLearn about infertility symptoms and types of treatment such as IVF, acupuncture, and natural methods to get pregnant. Read about infertility in men and women as well as treatment costs and success rates.
Ovulation & FertilityBoost fertility and increase your chances to conceive. Learn about ovulation calendars, diet, aging and other factors that can affect pregnancy.
Pelvic Inflammatory DiseasePelvic inflammatory disease (PID) is the most common and serious complication of sexually transmitted diseases (STDs), aside from AIDS, among women. The signs and symptoms of pelvic inflammatory disease include: fever, vaginal discharge with a foul odor, abdominal pain, including pain during intercourse, and irregular vaginal bleeding. Pelvic inflammatory disease can scar the Fallopian tubes, ovaries, and related structures and lead to ectopic pregnancies, infertility, chronic pelvic pain, and other serious consequences. Pelvic inflammatory disease treatment includes several types of antibiotics.
Surgery QuestionsSurgery is the branch of medicine that employs operations in the treatment of disease or injury. Prior to surgery you might consider asking your surgeon questions about the operation (procedure).
Symptoms of Serious Diseases and Health ProblemsLearn how to recognize early warning signs and symptoms of serious diseases and health problems, for example, chronic cough, headache, chest pain, nausea, stool color or consistency changes, heartburn, skin moles, anxiety, nightmares, suicidal thoughts, hallucinations, delusions, lightheadedness, night sweats, eye problems, confusion, depression, severe pelvic or abdominal pain, unusual vaginal discharge, and nipple changes.
The symptoms and signs of serious health problems can be caused by strokes, heart attacks, cancers, reproductive problems in females (for example, cancers, fibroids, endometriosis, ovarian cysts, and sexually transmitted diseases or STDs), breast problems (for example, breast cancer and non-cancer related diseases), lung diseases (for example, chronic obstructive pulmonary disease or COPD, lung cancer, emphysema, and asthma), stomach or digestive diseases (for example, cancers, gallbladder, liver, and pancreatic diseases, ulcerative colitis, or Crohn's disease), bladder problems (for example, urinary incontinence, and kidney infections), skin cancer, muscle and joint problems, emotional problems or mental illness (for example, postpartum depression, major depression, post-traumatic stress disorder (PTSD), mania, and schizophrenia), and headache disorders (for example, migraines, or "the worst headache of your life), and eating disorders and weight problems (for example, anorexia or bulimia).
Trying to Conceive
Trying to get conceive, or become pregnant can be challenging, frustrating, and an emotional rollercoaster for some couples. A couple can chart their progress, which may ultimately lead to a successful healthy pregnancy, or, when necessary, lead to discussions with a fertility specialist. If you're a woman, be aware of your menstrual cycle, and you can track when you are fertile during the month using the:
- Basal body temperature method
- Calendar method
- Ovulation method (cervical mucus)
About 10% of women in the US have problems getting pregnant, or carrying a pregnancy full term. Both men and women can have fertility problems. In fact, men and women each contribute about 1/3 when it comes to fertility problems. The other 1/3 are caused by a mixture of problems with both men and women or other problems that aren't identifiable.
Uterine CancerThough uterine cancer's cause is unknown, there are many factors that will put a woman at risk, including being over age 50, having endometrial hyperplasia, using hormone replacement therapy, obesity, using tamoxifen, being Caucasian, and/or having colorectal cancer. Symptoms of cancer of the uterus (endometrial cancer) include abnormal vaginal bleeding, painful urination, painful intercourse, and pelvic pain. Treatment depends on staging and may include radiation therapy or hormone therapy.
Normal vaginal bleeding (menorrhea) occurs through the process of menstruation. Abnormal vaginal bleeding in women who are ovulating regularly most commonly involves excessive, frequent, irregular, or decreased bleeding.
Causes of abnormal may arise from a variety of conditions that may include, uterine fibroids, IUDs, hypothyroidism, hyperthyroidism, lupus, STDs, pelvic inflammatory disease, emotional stress, anorexia nervosa, polycystic ovary syndrome (PCOS), cancers, early pregnancy.
The treatment for abnormal or irregular vaginal bleeding depends upon the cause.