What Is an Endometrial Biopsy?
An endometrial biopsy is a procedure in which a provider removes a small piece of tissue from the lining of the uterus, called the endometrium.
During the procedure, the provider inserts a thin, flexible tube through the cervix to remove a small piece of tissue from the endometrium. They can then examine that tissue under a microscope to look for abnormal cells or signs of cancer.
The procedure is often used to diagnose endometrial cancer. Your provider may also order an endometrial biopsy if you are experiencing abnormal bleeding or having trouble becoming pregnant.
Why Would I Need an Endometrial Biopsy?
An endometrial biopsy is most often used to determine if abnormal cells or signs of cancer are present in the lining of the uterus.
Your provider is likely to order the procedure if:
- A Pap smear detects irregular cells in your uterus.
- An ultrasound shows a thickened uterine lining.
Your provider may also recommend an endometrial biopsy if you’re experiencing abnormal bleeding. This can include:
Who is not a candidate for an endometrial biopsy?
You cannot have an endometrial biopsy if you:
- Are pregnant.
- Have acute pelvic inflammatory disease.
- Have an acute cervical or vaginal infection.
Women with certain blood-clotting disorders also may not be eligible for an endometrial biopsy.
Alternatives to an endometrial biopsy
For most people, an endometrial biopsy is the preferred way to check the uterine lining. It is very accurate, can take place in a provider's office, and usually takes no longer than 15 minutes. However, in some circumstances, doctors may use different tests to replace or augment an endometrial biopsy.
- Dilation and curettage — This minor surgery involves dilating the cervix. It allows doctors to remove a larger tissue sample than with an endometrial biopsy. This procedure may be necessary if the laboratory test requires a larger sample or if the endometrial biopsy is inconclusive.
- Transvaginal ultrasound — In this kind of imaging, an ultrasound wand is inserted into the vagina. Providers may order it along with an endometrial biopsy in cancer diagnosis. It is also often used to determine the cause of abnormal bleeding.
What Are the Risks and Complications of Endometrial Biopsy?
An endometrial biopsy is generally considered a very safe procedure.
Patients report only mild side effects, including:
- Light bleeding or spotting.
- Mild cramping.
In rare cases, complications can be more severe and include:
- Infection.
- Perforation of the uterine lining.
- Prolonged bleeding.
What Should I Expect from an Endometrial Biopsy?
An endometrial biopsy is a safe procedure that takes little preparation. It typically occurs in a provider's office and does not require a hospital visit or anesthesia.
Some women may need or prefer anesthesia due to issues with previous procedures or past trauma. Talk to your provider to determine the best plan for you.
Before: How to prepare for an endometrial biopsy
- Talk to your provider about taking pain medication, like ibuprofen or acetaminophen, before the procedure. It may help to lessen cramping.
- Tell your provider the medications you take regularly, particularly if you take blood thinners. Your doctor may tell you to stop taking certain medications in the days before the procedure.
- Your provider may order a pregnancy test before the procedure. Pregnant women cannot undergo an endometrial biopsy.
How long does an endometrial biopsy take?
The procedure can take place in your provider's office and typically takes no longer than 15 minutes.
During your endometrial biopsy
- Much like a regular pelvic exam, you will need to undress from the waist down, cover yourself with a sheet, lie on your back, and place your feet in stirrups.
- Your provider will insert a speculum into the vagina to see the cervix. They may also use a topical numbing solution on the cervix to make you more comfortable.
- Your provider will then use a sterilized instrument to grasp the cervix and keep it still while inserting a thin, flexible tube into the uterus.
- The tube removes a small piece of tissue from the uterine wall, or endometrium. Your provider can then send that piece of tissue to the lab for testing.
You may experience pain or cramping during the procedure. For most women, the discomfort is mild. However, some women may experience more severe pain.
After: Recovery after an endometrial biopsy
In the days after an endometrial biopsy, you will likely experience mild cramping and light bleeding. You may want to wear a sanitary pad, but you should not use tampons for several days following the procedure.
You should be fully recovered in about 48 hours.
When to call your doctor about problems following an endometrial biopsy
Most people recover quickly from an endometrial biopsy, but complications are possible.
You should call your doctor if you experience any of the following symptoms:
- Bleeding that is heavy or lasts more than two to three days.
- Cramping that is severe or lasts more than two to three days.
- Foul-smelling discharge.
- Fever or chills.
When will I know the results of my endometrial biopsy?
You will likely receive the results of your endometrial biopsy in about a week. A normal biopsy result means no abnormal cells were detected in your tissue sample. Endometrial biopsies with abnormal results could have many causes.
Some of the most likely are:
- Endometrial cancer — Endometrial cancer forms in the cells of the uterine lining and typically develops after menopause.
- Hyperplasia — This condition is also known as precancer. It is caused by abnormal growth or changes in cells.
- Infection — Abnormal biopsy results can be caused by infection.
- Uterine fibroids — These are noncancerous tumors that grow in the uterus. Some women experience bleeding due to these fibroids. Other women may have no symptoms.
- Uterine polyps — These are fingerlike growths in the lining of the uterus. They are typically not cancerous but can cause bleeding and other complications.
What percentage of endometrial biopsies show cancer?
The number of endometrial biopsies that are considered cancerous varies, but they are generally considered low.
The chance of developing endometrial cancer increases with age and other risk factors, including:
- Age over 50.
- Diabetes diagnosis.
- Family history of reproductive or colon cancer.
- First menstruation at an early age.
- History of endometrial hyperplasia, or precancerous cells in the uterine lining.
- Late menopause.
- Previous cancer diagnosis.
- Taking the breast cancer drug tamoxifen.
- Using estrogen replacement therapy without progesterone.
- Obesity.
By UPMC Editorial Staff. Last reviewed on 2026-08-11.
