Endometrial biopsy

Overview

An endometrial biopsy is a simple procedure where a doctor takes a small sample of the lining of your womb (the endometrium) to check for any problems. It is often done to find out why you have abnormal bleeding.

Yes, endometrial biopsy is a common and safe procedure used to investigate uterine health.

It is most often performed on women who have unusual bleeding, such as very heavy periods, bleeding between periods, or bleeding after menopause.

Symptoms

Common symptoms

• Heavy or prolonged menstrual bleeding
• Bleeding between periods
• Bleeding after menopause
• Irregular periods

Symptoms in children

• Abnormal vaginal bleeding before puberty (though this is rare and needs urgent medical assessment)

Symptoms in older adults

• Any bleeding after menopause
• Thinning or watery discharge tinged with blood

Causes

Main causes

• To investigate the cause of abnormal bleeding
• To check for conditions like polyps, fibroids, or endometrial hyperplasia (thickening of the womb lining)
• To rule out or diagnose endometrial cancer

Risk factors

• Age (risk increases after menopause)
• Obesity
• Hormone imbalances (e.g., polycystic ovary syndrome)
• Taking oestrogen without progesterone
• Family history of uterine or colorectal cancer

When to see a doctor

See a doctor urgently if:

• If you have sudden, very heavy bleeding or severe belly pain

Book a routine appointment if:

• If you notice any unusual bleeding, such as bleeding between periods or after menopause, make an appointment with your GP or gynaecologist.
• If your periods have become very heavy, prolonged, or irregular without a clear cause.

Diagnosis

An endometrial biopsy is often recommended after a pelvic exam or ultrasound shows something abnormal. The biopsy itself is a key step in diagnosing the cause of your symptoms.

Tests that may be done

• Pelvic ultrasound (to look at the womb lining)
• Endometrial biopsy (tissue sample)
• Sometimes a hysteroscopy (a camera test) is done as well

What to expect at your appointment

The biopsy is done in a clinic. You lie on an exam table, the doctor inserts a thin, flexible tube into your womb and gently takes a small sample of the lining. It lasts a few minutes. You might feel cramping, but it usually goes away quickly. You can go home the same day and may have mild spotting.

Treatment

Treatment depends entirely on the biopsy results. Many findings are harmless, but if there is a problem, your doctor will discuss the best options with you.

Self-care at home

• Rest for the rest of the day after the biopsy if you feel sore
• Use a sanitary pad for any light spotting – no tampons
• Avoid heavy lifting or vigorous exercise for a day or two

Medical treatments

If the biopsy shows a benign (non‑cancerous) condition, treatment may include hormonal medications or a minor procedure to remove polyps or fibroids. If the result shows precancerous changes or cancer, treatment may involve medication, hormone therapy, or surgery such as removal of the womb (hysterectomy). Your doctor will explain what is best for your specific situation.

When is surgery considered?

Surgery, such as a hysterectomy, may be recommended if the biopsy confirms endometrial cancer or if precancerous changes do not respond to other treatments. Your healthcare team will discuss all options with you.

Living with this condition

After a biopsy, you can usually return to normal activities the next day. If you have ongoing symptoms like heavy bleeding, your doctor will help you manage them.

Lifestyle tips

• Keep a record of your bleeding pattern to share with your doctor
• Maintain a healthy weight to reduce hormone‑related risks
• Avoid smoking and limit alcohol

Diet and exercise

Eat a balanced diet rich in fruits, vegetables, whole grains, and lean proteins. Gentle exercise like walking can help with overall health and stress. If you are waiting for results or treatment, try to stay active but listen to your body.

Mental health and emotional wellbeing

Waiting for biopsy results can be stressful. It is normal to feel anxious or worried. Talk to your doctor or a counsellor if these feelings are overwhelming.

Prevention

You cannot always prevent conditions that require a biopsy, but maintaining a healthy lifestyle can lower your risk of endometrial problems.

Screening programmes

There is no routine screening for endometrial conditions, but if you have risk factors, your doctor may suggest regular ultrasounds or biopsies.

Complications

If left untreated

• If an underlying condition like endometrial hyperplasia or cancer is not treated, it may worsen over time
• Chronic heavy bleeding can lead to anaemia (low iron) and fatigue

Long-term outlook

The outlook is very good. Most endometrial biopsies show benign (non‑cancerous) results. Even when a problem is found, treatments are effective, especially when caught early. Your healthcare team will support you every step of the way.

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