Endometrial Biopsy
Testing For Uterine Cancer And Causes Of Abnormal Periods

Endometrial Biopsy

Contents

• What Is Endometrial Biopsy?
• Why Is It Performed?
• How Is The Test Done?
• What Will The Test Results Show?
• Who Should Not Have The Test?
• What Complications Are Associated With It?
• How Much Does It Cost?

Related Articles:

List of Medical Tests
Cancer Biopsy

What Is Endometrial Biopsy?

An endometrial biopsy is a procedure that involves taking a sample of cells from the lining of the womb (endometrium). The sample is sent to a laboratory and checked under a microscope for signs of endometrial cancer (cancer of the womb). It does not require hospitalization and can be carried out a the doctor’s office. Endometrial biopsy is a blind procedure, which means the doctor cannot directly view the uterus. For this reason, occasionally it is accompanied by imaging studies such as transvaginal ultrasound or hysteroscopy.

Why Is It Performed?

Your doctor may order this test to find the cause of:

• Heavy periods (Menorrhagia)
• Irregular periods (Oligomenorrhea)
• Missed periods (amenorrhea)
• Bleeding after menopause.
• Thickened endometrial lining which was spotted on an ultrasound scan.
• Bleeding after taking hormone therapy drugs such as tamoxifen for breast cancer.
• Infertility, see infertility testing.

How Is The Test Done?

The patient lies on her back with her feet in stirrups. The doctor inserts a speculum into the vagina to keep it stretched open. The cervix is sprayed for 5 seconds with benzocaine anesthetic and cleaned with a povidone-iodine solution. Next it is clamped in place with an instrument called a tenaculum. A cervical dilator may be placed into the cervix so that it can be stretched opened. A small dilator is used first, followed by successively larger dilators. When the cervix is sufficiently dilated the doctor passes a small hollow plastic tube (catheter) through it and into the uterine (womb) cavity. Using suction, a small amount of endometrium tissue is removed through the tube. The suctioning takes about a minute. It may be slightly uncomfortable and cause some menstrual-like cramps. Some physicians like to take 2 samples of tissue. When completed, the tenaculum is gently removed. Pressure with cotton swabs may be applied to the cervix if there is some bleeding. Finally, the speculum is removed. The tissue samples are then sent to a lab for testing by a pathologist.

How Should I Prepare For The Test?

There are no special instructions in preparing for this biopsy. You may want to take a painkiller like Tylenol or ibuprofen an hour before the procedure to reduce cramping.

What Will The Test Results Show?

Normal Results
A normal result is where the cells show no abnormalities. If the patient continues to experience excessive vaginal bleeding, other diagnostic tests will be ordered.

Abnormal Test Result
Abnormal menstrual periods could be caused by:

• Endometrial cancer
• Endometrial hyperplasia (precancer)
• Uterine polyps
• Uterine fibroids
• Hormone imbalance which could be a cause of infertility
• Infection of the womb

Who Should Not Have The Test?

Women with the following conditions should not undergo endometrial biopsy:

• Pregnant
• Cervical cancer
• Acute pelvic inflammatory disease
• Blood clotting disorders

Additionally, a doctor may not offer the procedure in cases of:
• Morbid obesity
• Severe cervical stenosis (passage way of the cervix is narrow or completely closed)
• Severe pelvic relaxation with uterine prolapse (pelvic muscles are not strong enough to support the uterus, so it drops down into the vagina).

What Complications Are Associated With Endometrial Biopsy?

Tight Cervix
It can be difficult for the catheter to go up into the uterus in perimenopausal and menopausal patients. The internal cervix tends to be tighter in this category of patients. Because of the discomfort this causes, some doctors insert a seaweed laminaria dilator in the patient the morning of the test. This natural dilator gently, and slowly opens the cervix. It can be removed in the afternoon and the test easily performed.
Cramps
Many women experience cramping during and after the procedure. Taking an anti-inflammatory painkiller like ibuprofen an hour before the procedure can significantly reduce cramps.
Infections
There is some risk of a urinary tract infection due to bacterial infection after the procedure. For this reason some doctors prescribe 500 mg twice daily, for 4 days following the procedure.

How Much Does It Cost?

The average cost of an endometrial biopsy is about $200.

Related Articles on Diagnostic Testing

For more information, see the following:

• Reproductive system disorders: A to Z of symptoms and causes.
• Vaccination for women: Age group from 19 to 90.
• Hospital departments explained: Find your way around hospitals.

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