Endometrial Biopsy

An endometrial biopsy is a procedure done medically and involves taking a sample of the tissue inside the lining of the uterus. The tissue is examined through a histologic evaluation and will allow your doctor at GYN LA to form a diagnosis.

The procedure of an endometrial biopsy should not be performed if a woman is pregnant, so if you are in your reproductive years, the doctor may ask for a pregnancy test before scheduling this test. It is typically performed on women over the age of 35 and can be used by your doctor to rule out or confirm endometrial cancer as well as to check hormone levels.

When is an Endometrial Biopsy Performed?

An endometrial biopsy is scheduled by your doctor at Gyn LA to find the cause of irregular or heavy bleeding. It is one of the most common tests done to check for endometrial cancer. Generally, this biopsy can be done at the offices of Gyn LA; however, it must be performed by a physician who has experience and knowledge of how this test is conducted.

The endometrial biopsy is typically done on women over the age of 35, and before you go into menopause, in some cases, this biopsy can be done if a woman is having trouble getting pregnant to check for any issues with her endometrium.

• Endometrium

The endometrium is the star of your reproductive system. It has a key role during your menstrual cycle, as well as your pregnancy. Sometimes the endometrium is referred to as the endometrial lining, as it is the tissue that lines the uterus, much like wallpaper lines, a kitchen wall.

The function of the endometrium is to prevent adhesions between the walls of the myometrium. It also maintains the patency of your uterine cavity. During your menstrual cycle, the endometrium will grow into a thick, blood vessel-rich glandular layer of tissue.

An endometrial biopsy may be scheduled by your doctor to:

• Find out why you are experiencing postmenopausal bleeding or uterine bleeding which is considered abnormal
• Screen to check for endometrial cancer
• Evaluate your fertility
• Test your response to hormone therapy

The procedure of an endometrial biopsy cannot be done if you are pregnant, nor should you have one if:

• You suffer from a blood clotting disorder
• You have an acute pelvic inflammatory disease
  • Acute Pelvic Inflammatory Disease (PID) is an infection of female reproductive organs. In your lower abdomen is your pelvis, which is where your uterus, cervix, ovaries, and fallopian tubes are. PID (Acute Pelvic Inflammatory Disease) affects about five percent of the women in the United States, according to the Department of Human Services. PID can be caused by several different types of bacteria, including the same bacteria that cause STIs (sexually transmitted infections), gonorrhea, and chlamydia. PID commonly occurs when the bacteria enter the vagina and cause an infection. Over time this infection can move into your pelvic area.
  • PID can become an extremely dangerous condition; even life-threatening should the infection spread to your blood system. Risk factors for developing acute pelvic inflammatory disease include:
    • If you have chlamydia or gonorrhea
    • Have had a previous sexually transmitted disease
    • Have sex under the age of twenty-five
    • Have multiple sex partners
    • Have recently had an intrauterine device inserted
    • Douching
    • Have a history of pelvic inflammatory disease
• You have an acute vaginal or cervical infection
  • A cervical or vaginal infection, also called vaginitis, is a condition that can cause inflammation or an infection of your vagina. Vulvovaginitis is an inflammation of both your vulva and vagina. Your vulva is the outer part of your vagina. Some vaginal infections can develop symptoms, such as:
    • A change in how much discharge you expel from your vagina
    • Burning or pain during urination
    • Spotting or vaginal bleeding
    • Itching of the vagina
    • The color changes in your vaginal discharge
    • Painful intercourse
• You have cervical cancer
  • Cervical cancer is a form of cancer that begins in the cervix. The cervix is a hollow cylinder and connects the lower part of the woman’s vagina to your uterus. Most times, cervical cancer starts in cells on the surface of your cervix. This form of cancer is a leading cause of death in American women. Since testing has become available to prescreen this cancer, the number of cases has dropped.
  • You may not even be aware you have cervical cancer in its early stages, as there are no symptoms when it begins. Symptoms don’t appear until cancer reaches later stages.  When symptoms do appear, they can include:
    • Unusual bleeding after sex, bleeding after you've entered menopause
    • Vaginal discharge with a different odor or appearance
    • Pelvis pain
    • A need to urinate more often
    • Pain while urinating

• You suffer from a severe narrowing of the cervix or cervical stenosis

What are the Symptoms for Needing Endometrial Biopsy?

Your doctor at Gyn LA may suggest you have an endometrial biopsy if you are experiencing any of these symptoms:

• Having irregular menstruation
• You are experiencing abnormal bleeding due to taking a breast cancer medicine called, tamoxifen
• Your menstrual cycle has become lengthier with more massive bleeding
• You have gone or are going through menopause and start bleeding
• You have had an ultrasound, and it was discovered you have a thickened uterine lining

How is an Endometrial Biopsy Performed?

If you need an endometrial biopsy, it will generally be performed at the clinic of Gyn LA and doesn't typically require anesthesia. You are placed on the exam table, and in the same position as when you have a Pap test. Your feet are placed in the stirrups, and your doctor will insert a speculum into your vagina so the cervix can be seen.

The doctor will clean the cervix with a special solution, and then hold the cervix steady with another tool, so that a thin suction tube can be inserted into your uterus to collect a tissue sample. This sample of tissue can show if there have been cell changes due to tissues that have become abnormal. It can also show the doctor if you've experienced any variations in levels of your hormones.

By taking a small sample of your endometrial tissue, the doctor will be able to diagnose certain medical conditions you may be suffering. This sample will also show if you have a uterine infection, such as endometritis. The endometrial biopsy can help your doctor diagnose certain medical conditions or cancers, as well as rule out certain diseases. The tissue will then be sent to the lab, where a pathologist will analyze the cells.

After your biopsy procedure, it is recommended you don't use tampons, have intercourse, or douche for a few days after the test. Your doctor will discuss precisely how long they feel you should wait, depending on your health history. It is also not recommended to swim, go into a hot tub, or take a bath for about a week after an endometrial biopsy. Your doctor at Gyn LA will also discuss how long you should wait for each of these depending on your medical history.

After the procedure, you may experience minor cramping similar to what you experience during your menstrual cycle. If you do have these cramps, you can take over the counter pain medication such as acetaminophen or ibuprofen to help relieve the pain. The endometrial biopsy procedure should only take from five to fifteen minutes.

The endometrial biopsy is the most common test your doctor at Gyn LA can perform to diagnose endometrial cancer. After your doctor sends your sample tissue to the lab for analysis, it should take about a week to get the results. Your doctor will share those results with you and discuss any treatment plan if necessary, depending on the results of the analysis.

Are There Risks with an Endometrial Biopsy?

An endometrial biopsy is a safe procedure, but there is a chance of infection and bleeding. The uterus wall could get nicked by the tools used during the removal of the tissue sample during the biopsy, but it is very rare.

What do Endometrial Biopsy Results Mean?

About a week after your endometrial biopsy procedure, the lab should have the results back to your doctor at Gyn LA. These results could show:

• Fibroids or polyps in your uterus
• An infection in your uterus, such as endometritis
• Endometrial cancer
• A problem with your thyroid

Your doctor at Gyn LA will go over these results and discuss any treatments, if any, are needed. The test results could be returned inconclusive, or unclear whether or not there are cancer cells present in your uterus. If your results are returned as inconclusive, your doctor may recommend a more involved medical test called a dilation and curettage (D & C). With a dilation and curettage, the doctor will take a larger sample of your uterus lining for testing.

The endometrial biopsy is not a perfect test, as it involves a random tissue sample, so it is possible to miss precancerous or cancerous growths. If you are experiencing symptoms and your doctor feels you need an endometrial biopsy, but it is inconclusive, then the D & C may have to be performed to determine why you have the symptoms.

• Dilation and Curettage (D & C) is a brief surgical procedure. For this test, your cervix is dilated. A special tool is used to scrape the lining of the uterus. Knowing how this procedure is done, may minimize any anxiety you may be experiencing before your appointment.

The D & C is recommended for several reasons, such as an inclusive endometrial biopsy or to remove tissue from your uterus after a miscarriage or abortion. It can also be recommended to remove small pieces of the placenta after childbirth. It is done after these situations to prevent heavy bleeding or infections.

It may also be recommended you have a D & C to diagnose or treat growths such as uterine cancer, hormonal imbalances, polyps, or fibroids. The scraping sample of your uterine will be viewed under a microscope in the lab to look for abnormal cells.

The D & C can be performed in the clinic at Gyn LA and usually takes about fifteen minutes. You may be required to stay at the clinic for up to five hours, however, for monitoring. Before the procedure is performed, you will need to give your complete medical history and sign a consent form. Be sure your doctor is aware of:

- You suspect you are pregnant

- You have allergies to any medications

- You have a bleeding disorder or are taking any blood-thinning medications

Anesthesia is administered before a D & C is performed, which your doctor will go over with you before administering it, as there are choices of:

- Having general anesthesia so that you are not awake during the procedure

- Having epidural or spinal anesthesia, which blocks your feelings from the waist down

- Having local anesthesia, so that you are awake, but the area around your cervix will be numbed

Before the procedure begins, you will want to make sure your bladder is empty, and you will then lie down on the exam table as you do during a Pap test. The procedure will involve two primary steps:

- Dilation or widening of your lower part of the uterus to allow the insertion of an instrument. There are cases where the doctor uses a slender rod to apply  medication that will soften the cervix, so it widens.

- Curettage will involve the scraping of lining in your uterus and removing the contents with a spoon-shaped instrument called a curette. There are cases where  the scrapings are also removed with a cannula to suction them out.

The scrapings removed during the D & C are then sent to the lab for testing. In some cases, the doctor may also view inside your uterus after a D & C with hysteroscopy and remove fibroids or polyps if they are discovered.

Find An Endometrial Biopsy Procedure Near Me?

If you are experiencing symptoms that indicate you need an endometrial biopsy, call Gyn LA, and discuss this procedure with our experienced and knowledgeable staff. It is our goal at Gyn LA to treat our patients with compassion and confidence using the highest standard of care. Call 310-375-8446 today and schedule an appointment. We want you on the road to recovery as soon as possible, and will give you an optimal medical experience to begin your healing.