Why do you need an Endometrial Biopsy?

Jane is undergoing treatment for endometrial cancer. She wanted to share her story much earlier. However, she was too depressed and shocked after the diagnosis of cancer was made. 

The treatment started about 6 months back and Jane has not yet recovered fully. The doctor said she might need chemotherapy and radiation for the next few months or so.


She was suffering from heavy bleeding for more than 2 years before the diagnosis was made. Sometimes, her periods used to last for more than 7 days. At times, her cycles were as short as just 15 days. She was having a flow for 10 to 15 days a month. 


However, in spite of all these symptoms, Jane did not feel it was necessary to see a doctor. She was 45 years old then and she was sure all of these symptoms were due to menopause. Jane knew menopause causes irregular menses. So, she just ignored the symptoms and decided to wait patiently for menopause to get over. When this continued even after 2 years, she started getting nervous. The heavy bleeding was taking a toll on her health. She had become very weak and used to feel tired most of the time. 

Slowly, Jane began to realize that her heavy bleeding was not due to menopause. She finally decided to contact a gynecologist when her routine blood report showed the hemoglobin level was less than 8 (the normal range is between 12 to 15).

When Jane told the gynecologist the symptoms she was suffering from, her doctor advised her to do some tests including blood tests to check hormonal levels, endometrial biopsy, and a PAP smear. 

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The endometrial biopsy revealed there were cancerous changes in these tissues. Jane was shocked. She had never expected this. Above all, she was feeling guilty for ignoring the symptoms for so long. 

However, her doctor was very supportive. She assured Jane that with proper treatment, Jane would recover fully. Yet, Jane struggled with depression for a few months. She felt hopeless, to say the least.

The doctor also advised her to make a few changes in her diet and prescribed a supplement to improve her hemoglobin levels. 

Slowly, there was an improvement in her symptoms and overall health as the cancer treatment started showing encouraging results. Jane’s periods were less troublesome after two or three months. The follow-up endometrial biopsy showed the tissues were responding favorably to cancer treatment. 


Now, Jane is more positive about the treatment. She is sure she would recover slowly but surely. However, she still has a regret of not seeing the doctor earlier. This is why; Jane is sharing her experience so that other women are aware of how a simple test like endometrial biopsy can help them for an early detection of cancer. Jane would urge all women to do this test routinely so that a condition like hers can be diagnosed earlier. 


Laboratory, imaging, and other tests are usually recommended for patients to rule out or confirm the diagnosis of an illness. There are several diagnostic tests that can help women, like Jane, in the diagnosis of conditions affecting their reproductive organs. 

However, it is not just the women who suffer from symptoms who need to perform these tests. Some tests need to be performed even in the absence of any symptoms. These tests help in early diagnosis of diseases and even assess future risk of development of any illness. 

Some tests also work as a preventive tool so that the condition can be detected before it flares up and causes serious complications. Endometrial biopsy is one such test that can help women in the early diagnosis of a number of diseases. Here is a brief discussion about what endometrial biopsy is and why women need to perform this test.   


What is an Endometrial Biopsy?

An endometrial biopsy is a diagnostic procedure in which a small part of the tissue is obtained from the inner lining of the uterus called the endometrium. The tissues are later examined under a microscope for the detection of any abnormality or cellular changes that can lead to disease development. The removed tissue is usually examined for cancerous changes. 

It is a simple procedure that is usually performed in the gynecologist’s office. It can be performed without anesthesia. 

During the procedure, the doctor would insert a speculum through the vagina to open and hold it so that the cervix can be viewed clearly. The cervix is then cleaned with a solution to prevent the risk of infection. 

This is followed by the insertion of another instrument to hold the cervix in a steady position. Then, a thin suction tube is inserted gently into the uterus and a small part of endometrial tissues is collected through the tube.  

The tissue is then sent to a pathology laboratory for the analysis of the cells for the detection of any abnormality or cancerous changes.

The women may be advised to avoid using douches, tampons, or have intercourse for one or two days after the endometrial biopsy. In some cases, the woman may be advised to avoid swimming and going in a hot tub for about one week after the procedure. 

Some women experience mild cramping similar to abdominal cramps occurring during menses during the procedure. However, the pain is minimal and may not require any active treatment. The entire procedure lasts for about 5 to 15 minutes.

Now that you have an idea of what an endometrial biopsy is and how it is performed, let us move further to understand why women must be aware of the need for this test. 


Why should women not ignore the need for an Endometrial Biopsy?

Endometrial biopsy is one of the most accurate tests that can be performed through a simple procedure to detect an illness. Most conditions affecting the uterus such as uterine cancer, endometrial cancer, or endometrial hyperplasia do not cause any symptoms until the disease has progressed considerably. 

Also, women often ignore the mild to moderate symptoms of these conditions such as heavier bleeding,  spotting between periods, or frequent periods thinking of them as a normal part of menopause. 

Since endometrial cancer tends to affect women nearly at or after the menopausal age, the chances of these symptoms getting ignored are high. 

Women realize they could be suffering from a serious health condition only when the symptoms become severe or persist even after menopause should have been over. 

However, the delayed diagnosis due to any reason can result in the growth of the cancer mass. It may also lead to the spread of cancer cells to surrounding structures such as the fallopian tubes, ovaries, cervix, or vagina. 

Hence, women must be aware of the diagnostic tests that can help them in the early diagnosis of cancers or other conditions affecting the uterus. 

An endometrial biopsy can be performed as a preventive tool even when there are no symptoms. This can help women avoid the growth or spread of cancer by allowing them to seek early medical intervention in case the test reveals any abnormality. 

Here are some indications for an endometrial biopsy that women must keep in mind. The symptoms discussed beneath can be considered a sign that the woman needs an endometrial biopsy for the detection of the underlying illness. 


Why do you need an Endometrial Biopsy? 


Women need to undergo endometrial biopsy even when they are apparently healthy and are not suffering from any symptoms or illness. Most diseases affecting the uterus or endometrium are more common in women above the age of 35 years. Hence, all women who have crossed this age are advised to do an endometrial biopsy for early detection of the illness. 

It should be noted that most uterine and endometrial conditions do not cause any obvious symptoms. The absence of evident symptoms can allow the disease to progress and cause serious complications. This is when a diagnostic test like an endometrial biopsy can help to detect the condition at an early stage. 

Beginning the treatment of endometrial or uterine cancer before it has spread or grown considerably can ensure faster recovery of women and also increase the chances of their survival. Women who are above 35 years of age and have no symptoms should ideally do endometrial biopsy once every year as a preventive tool. 

Menstrual Irregularities

Women who suffer from menstrual irregularities should do an endometrial biopsy for early detection of endometrial cancer. This condition often causes heavy or prolonged periods, and irregular bleeding or spotting. These symptoms can also occur due to other diseases such as uterine fibroids and ovarian cancer. An endometrial biopsy would help women arrive at the correct diagnosis, thus allowing them to seek proper medical intervention. 


Bleeding After Menopause

Women who suffer from vaginal bleeding after menopause should do an endometrial biopsy as it could be a sign of endometrial or uterine cancer. 


Use of Tamoxifen

Tamoxifen is a commonly used medication for the treatment of breast cancer. Women who are undergoing treatment for breast cancer with tamoxifen are advised to do an endometrial biopsy as this drug is known to increase the risk of endometrial cancer. Tamoxifen works by acting against the growth-stimulatory effect of the female hormone, estrogen, on the breast tissue to prevent cancerous changes. However, it also acts like estrogen on other tissues such as the uterus thus triggering abnormal growth in the endometrium. Tamoxifen may also increase the risk of uterine sarcoma, a form of cancer affecting the muscles in the uterine wall. Hence, women who are prescribed tamoxifen are advised to do an endometrial biopsy to evaluate the effect of this medication on the uterus. 


Use of Toremifene

Another medication used to lower the risk of breast cancer called toremifene can also increase the risk of endometrial hyperplasia, a condition caused due to the overgrowth of the endometrium. 

Though hyperplasia is not cancerous in nature, it may later develop into cancer. Hence, women who are using toremifene are advised to perform an endometrial biopsy to assess the effect of this drug on the endometrial tissues. 


Abnormal Ultrasound Report

Women who have had an ultrasound of the pelvic organ showing abnormal results such as a thickened uterine lining can undergo an endometrial biopsy to rule out cancerous changes in the tissues. 

Evaluation of Infertility

Women who are suffering from infertility are often advised to do an endometrial biopsy to detect the possible causes of the condition. The test may reveal any abnormality that can prevent conception and help the gynecologist suggest appropriate treatment to manage the underlying disease thus increasing the chances of conception.


Abnormal Papanicolaou Smear 

Women who have undergone Papanicolaou smear, also called PAP smear, showing atypical cells of endometrial origin need an endometrial biopsy for further evaluation. The test can help to assess the endometrial health and allow for early medical intervention in case cancerous changes are detected. 

Recovery Phase

Women need to undergo endometrial biopsy more frequently when they are undergoing treatment for endometrial or uterine cancer. During treatment, the test may be performed once in 3 months or more frequently as recommended by the gynecologist. The test would help to assess whether the patient is responding favorably to the treatment and allow the physician to modify the therapies accordingly. 

Women who have recovered from cancer and do not need any active treatment should also perform endometrial biopsy once in 6 months for the detection of relapse or spread. 

Family History

The risk of cancer is higher when the person has a family history of the same. Women who have a strong family history of cancer of the reproductive organs including the uterus, endometrium, ovaries, cervix, or vagina should contact a gynecologist to check if they need endometrial biopsy more frequently than once a year. 

They should also seek physician’s advice to find if they should start doing this test as a preventive tool at an age earlier than 35 years. 



An endometrial biopsy is a common and accurate test recommended for women for early diagnosis of endometrial cancer. Depending on the results, the gynecologist may prescribe an appropriate treatment to women to help them stay healthy and avoid further progression of the condition. 



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