Endometrial biopsy is a procedure in which a tissue sample is taken from the lining of the uterus (endometrium), and is checked under a microscope for any abnormal cells or signs of cancer.

This procedure may be done with or without anesthesia. You will lie on your back with your feet in stirrups.

The health care provider will do a pelvic examination, and will insert an instrument (speculum) into the vagina to hold it open and see the cervix.

The cervix is cleaned with an antiseptic liquid and then grasped with an instrument (tenaculum) to hold the uterus steady. A device called a cervical dilator may be needed to stretch the cervical canal if there is tightness (stenosis). Then a small, hollow plastic tube is gently passed into the uterine cavity.

Gentle suction removes a sample of the lining. The tissue sample and instruments are removed. A specialist called a pathologist examines the sample under a microscope.

Adults need no special preparation for the biopsy.

Adolescent test or procedure preparation (12 to 18 years)

The instruments may feel cold. You may feel some pain when the cervix is grasped. You may have some cramping as the instruments enter the uterus and the sample is collected.

The test is done to find the cause of:

• Abnormal menstrual periods (heavy, prolonged, or irregular bleeding)
• Bleeding after menopause
• Bleeding from taking hormone replacement medications

The test is usually done in women over age 35.

This test can also be used to test for endometrial cancer. Sometimes, it is used as part of the diagnosis in women who have been unable to become pregnant (see infertility).

The biopsy is normal if the cells in the sample have no abnormalities.

Abnormal menstrual periods may be caused by:

• Endometrial cancer
• Uterine fibroids
• Uterine polyps

If the lining is being tested for infertility, the sample may determine if hormones are properly stimulating the lining so that the fertilized egg can implant.

Other conditions under which the test may be performed:

• Abnormal bleeding if a woman is taking the breast cancer medication, tamoxifen
• Anovulatory bleeding
• Endometritis

• Infection
• Making a hole in (perforating) the uterus or tearing the cervix (rarely)
• Prolonged bleeding
• Slight spotting

Katz VL, Lentz GM, Lobo RA, Gershenson DM. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby; 2007.