Endometrial Biopsy in Women: Why It Is Done and How It Is Performed

An endometrial biopsy is a procedure in which a small tissue sample is taken from the inner lining of the uterus (endometrium) for examination. It is an important diagnostic method used to investigate abnormal uterine bleeding, hormonal imbalances, or suspected cancer. The procedure is usually brief and does not require hospitalization.

Why Is an Endometrial Biopsy Performed?

This biopsy is used to diagnose many gynecological conditions:

1. Abnormal Uterine Bleeding
   • Menstrual irregularities (very long, short, or heavy periods)
   • Postmenopausal vaginal bleeding
2. Endometrial Cancer or Precancerous Stages
   • To determine whether there is abnormal cell growth in the uterine lining (endometrium).
   • To diagnose cases of thickened endometrium after menopause.
3. Hormonal Imbalances and Infertility Investigations
   • A biopsy may be taken to evaluate whether the uterine lining is suitable for ovulation and implantation.
   • Changes in the endometrium caused by hormonal disorders such as Polycystic Ovary Syndrome (PCOS) can be examined.
4. Endometrial Hyperplasia (Thickening of the Uterine Lining)
   • To check whether uncontrolled estrogen production is causing excessive growth of the endometrium.

How Is an Endometrial Biopsy Performed?

• Duration: Usually takes 5–10 minutes.
• Anesthesia: Often not required, but in some cases mild sedation or local anesthesia may be used.

Procedure steps:

1. The patient is placed in the gynecological examination position.
2. The vagina is opened with a speculum, and the cervix is visualized.
3. The cervix is cleaned with an antiseptic solution.
4. A thin and flexible plastic cannula or a special instrument called a pipelle is inserted into the uterus.
5. A gentle suction is applied to collect a small tissue sample from the endometrium.
6. The collected tissue is sent to the laboratory for microscopic examination.

After the Biopsy: What to Expect and Precautions

• Mild Cramps and Spotting: Some mild cramps and light bleeding may occur for a few days after the procedure.
• Infection Prevention: Vaginal douching should be avoided, and hygiene practices should be followed.
• Sexual Intercourse: Should be avoided for 1–2 days after the procedure.
• Pain and Discomfort: Mild pain can be managed with painkillers prescribed by a doctor.

Possible Risks and Side Effects

Endometrial biopsy is generally safe, but in rare cases, complications may occur:

• Severe bleeding (rare)
• Uterine infection (if vaginal discharge, fever, or severe pain occurs, medical attention is required)
• Uterine perforation (very rare)

Conclusion

Endometrial biopsy is a highly effective method for diagnosing gynecological conditions. Especially in cases of abnormal bleeding or suspected cancer, it enables early diagnosis and helps initiate appropriate treatment. The procedure is usually quick and relatively painless, but results must always be reviewed and evaluated by a doctor.