Endometrial biopsy

An endometrial biopsy (EMB) is a procedure that removes a small piece of tissue from the lining of the uterus, called the endometrium. This tissue is examined under a microscope to look for abnormal cells, hormone-related changes, infection, or other concerns. It’s most often done to find the cause of unusual uterine bleeding, but it can also help evaluate other conditions that affect reproductive health.

At Penn Medicine, our women’s health team diagnoses and treats a wide range of gynecologic conditions. We take a team-based approach, bringing together experts in imaging, pathology, fertility, and gynecologic cancer care. Whether you need help with a common concern or a complex diagnosis, you have access to advanced treatment options and specialists with deep experience in reproductive health.

An endometrial biopsy helps find the cause of both cancerous and noncancerous conditions. Endometrial sampling allows your care team to take a closer look at the cells inside the uterus if you have symptoms that need evaluation or if imaging shows something unusual.

There are many reasons to do an EMB procedure, including:

• Heavy, long, or irregular menstrual periods
• Abnormal uterine bleeding related to hormone therapy or medications
• Bleeding after menopause
• A thickened uterine lining seen on ultrasound
• Infections or growths like polyps and fibroids
• Cell changes found on other tests

An endometrial biopsy is done in an office setting and usually takes less than 15 minutes. You’ll lie on an exam table with your feet in stirrups, similar to a pelvic exam. Your provider will use a tool called a speculum to see the cervix and clean the area with a special liquid. A very thin, flexible tube is gently passed through the cervix into the uterus. Using light suction, a small sample of tissue is collected.

You might feel some cramping during these steps, like menstrual cramps, but the discomfort usually doesn’t last long. Once the sample is collected, the instruments are removed, and the procedure is over. The tissue is then sent to a lab, where specialists review the cells and prepare your endometrial biopsy results.

It’s normal to have some mild cramping or light bleeding for a few days after the procedure, so you may want to wear a sanitary pad. You may be asked not to use tampons or have sex for about one week. Your care team will let you know what’s safe based on your situation.

Call your care team if you have:

• Heavy bleeding that lasts more than two or three days
• Fever or chills
• Vaginal discharge that smells bad
• Severe pain that doesn’t go away with medicine

Endometrial biopsy results are usually available within one week. If the results are normal, no unusual cells were found. If the results are abnormal, it means the lab found changes that need more attention. Abnormal results do not always mean cancer.

Your care team will review the findings with you and explain what they mean. Sometimes no further treatment is needed. In other cases, you may need medicine, closer monitoring, or another procedure to gather more tissue, like a dilation and curettage. If precancer or cancer is found, you’ll be connected with specialists who focus on gynecologic cancer care and will guide you through next steps with clear information and support.

At Penn Medicine, we offer the advantage of being an academic medical center. This means our providers are at the forefront of research and use the latest technology to get you the most accurate answers. Because we work as one team, you’ll have access to any specialist you might need, from surgeons to fertility experts, without having to leave our network.