In-Office Procedures
In-Office · No Hospital · No General Anesthesia

Endometrial
Biopsy A tissue sample from the uterine lining — the first-line evaluation for abnormal bleeding and postmenopausal spotting.

Schedule a Gynecologic Visit
5–10 Min
Procedure Time
None
Anesthesia Required
1–2 Weeks
Pathology Results
Procedure
Endometrial Tissue Sampling
Setting
In-Office · No Hospital
Anesthesia
None Required
Duration
5–10 Minutes
Results
Pathology in 1–2 Weeks
In-Office Procedures

Endometrial Biopsy: Accurate Uterine Lining Evaluation In the Office

An endometrial biopsy obtains a small tissue sample from the uterine lining (endometrium) for pathologic analysis. It is the first-line evaluation for abnormal uterine bleeding, postmenopausal spotting, and suspected endometrial hyperplasia or cancer — and it is performed entirely in the office, without general anesthesia.

Dr. Andrei performs endometrial biopsy at both the Lapeer and Rochester Hills offices as a 5–10 minute procedure. A thin sampling catheter is passed through the cervix into the uterine cavity, and a small amount of tissue is collected by gentle suction. The specimen is sent to pathology and results are typically available within one to two weeks.

Endometrial biopsy is not the same as a dilation and curettage (D&C) — it requires no anesthesia, no dilation, no operating room, and no recovery time. Most patients return to normal activity the same day.

When Biopsy Is Recommended

Indications for Endometrial Biopsy

Dr. Andrei recommends endometrial biopsy when the uterine lining requires tissue-based evaluation. These are the most common clinical indications.

Abnormal uterine bleeding

Heavy, irregular, or unpredictable bleeding in premenopausal women when hormonal or structural causes have not been identified — biopsy evaluates the endometrium for hyperplasia or other pathology.

Postmenopausal bleeding

Any uterine bleeding after menopause requires endometrial evaluation to rule out endometrial cancer. Biopsy is typically the first step before imaging.

Thickened endometrium on ultrasound

An endometrial stripe greater than 4–5mm on transvaginal ultrasound in a postmenopausal patient, or thickening in a symptomatic premenopausal patient, warrants tissue sampling.

Tamoxifen therapy monitoring

Women taking tamoxifen for breast cancer treatment are at elevated risk of endometrial changes and may require periodic biopsy based on clinical guidelines and symptom status.

Abnormal Pap with glandular findings

Atypical glandular cells on a Pap smear may indicate endometrial pathology and require biopsy as part of the evaluation workup.

Infertility or recurrent implantation failure

Endometrial evaluation may be indicated as part of an infertility workup or prior to IVF when structural or receptivity issues are suspected.

What to Expect

The Endometrial Biopsy Procedure — Step by Step

Endometrial biopsy at Lapeer Women’s Health takes 5–10 minutes. No hospital, no sedation, no dilation. Most patients return to work and normal activity the same day. Taking 600–800mg ibuprofen one hour before your appointment is recommended.

1

Positioning and Speculum Placement

You are positioned as for a pelvic exam. A speculum is placed and the cervix is visualized. The cervix is cleaned with antiseptic solution. Dr. Andrei reviews the procedure and answers any questions.

2

Cervical Stabilization

A small instrument called a tenaculum is used to gently stabilize the cervix. This may cause a brief cramp. Local anesthetic to the cervix is available if preferred.

3

Uterine Sounding

A thin uterine sound measures the depth of the uterine cavity. This ensures accurate catheter placement. A brief cramp is common and expected at this step.

4

Tissue Sampling

The biopsy catheter (Pipelle) is advanced through the cervical canal into the uterine cavity. The inner stylet is withdrawn, creating gentle suction. The catheter is rotated and moved back and forth to collect a representative tissue sample. This step takes approximately 15–30 seconds.

5

Specimen to Pathology

The collected tissue is placed in fixative and sent to the pathology laboratory. Results are typically available within one to two weeks. Dr. Andrei reviews findings with you at a follow-up appointment or by phone.

What Biopsy Can and Cannot Detect
Endometrial biopsy is highly accurate for diffuse endometrial pathology — hyperplasia, endometrial cancer, and hormonal changes. It samples the lining without direct visualization and may miss focal lesions such as polyps. When biopsy results are insufficient or bleeding persists, hysteroscopy provides direct visualization of the entire uterine cavity and can be performed at the same office.
Before Your Appointment

Common Questions About Endometrial Biopsy

Most patients describe the biopsy as similar to a strong menstrual cramp lasting 15–30 seconds during the sampling step. The tenaculum and uterine sounding cause brief additional cramping. Taking 600–800mg of ibuprofen one hour before your appointment significantly reduces discomfort. Mild cramping after the procedure is expected and typically resolves within a few hours.
Take ibuprofen one hour before your appointment. You do not need to fast or arrange for a driver in most cases. Scheduling your appointment around your menstrual cycle is not required, though avoiding the heaviest flow days may be more comfortable. Let our office know if you are taking blood thinners.
Tissue specimens are sent to an external pathology laboratory. Results are typically available within one to two weeks. Dr. Andrei reviews all pathology findings with you directly — either at a follow-up appointment or by phone — and discusses next steps based on the findings.
No. A dilation and curettage (D&C) requires cervical dilation, anesthesia, and typically an operating room or procedure suite. An endometrial biopsy uses a thin sampling catheter through the natural cervical opening, requires no dilation or anesthesia, and is completed in the office in 5–10 minutes. The two procedures are not interchangeable.
If biopsy shows endometrial hyperplasia without atypia, treatment may include progestin therapy with repeat biopsy to confirm resolution. Atypical hyperplasia or endometrial cancer findings are discussed in detail with Dr. Andrei and appropriate referral or surgical planning is initiated. Most abnormal results are caught at an early, highly treatable stage.
In-Office
No Hospital Required
MD, PhD, FACOG
Board-Certified Gynecologist
5–10 Minutes
Procedure Duration
1–2 Weeks
Pathology Results
Schedule Your Biopsy Evaluation

Answers Without the Wait.
No Hospital, No Anesthesia.

Abnormal bleeding, postmenopausal spotting, or a thickened endometrium on ultrasound — endometrial biopsy provides tissue-based answers in a single office visit at Lapeer or Rochester Hills.

Lapeer Office
(810) 969-4670
Rochester Hills
(248) 923-3522

The information on this page is intended for educational purposes only and does not constitute medical advice. Individual symptoms, diagnoses, and treatment options vary significantly. Reading this content does not establish a physician-patient relationship with Dr. Ramona D. Andrei or Lapeer Women’s Health. If you are experiencing a medical emergency, call 911 or go to the nearest emergency room immediately. Please consult a qualified healthcare provider for advice specific to your situation. Content reviewed by Dr. Ramona D. Andrei, MD PhD FACOG.

Gynecologic care for women of every age

Lapeer Women’s Health — Lapeer
1245 N Main St
Lapeer, MI 48446
Lapeer: (810) 969-4670
Rochester Hills: (248) 923-3522

Lapeer Women’s Health — Rochester Hills
2710 S Rochester Rd, Suite 2
Rochester Hills, MI 48307

Serving patients in Lapeer, Rochester Hills, and surrounding communities throughout Southeast Michigan.