An endometrial biopsy is a medical procedure used to collect a small sample of tissue from the lining of the uterus, known as the endometrium. The sample is then examined under a microscope to check for any abnormalities or to make a diagnosis.
Endometrial biopsies are usually recommended around menopause for the following reasons:
Abnormal uterine bleeding: If you experience irregular or heavy menstrual bleeding, you may be asked to undergo a trans vaginal ultrasound to determine the endometrial thickness. Based on that, you may be asked to undergo an endometrial biopsy to determine the cause for the bleeding. It can help to understand the underlying pathology which could be hormonal causes, endometrial hyperplasia (overgrowth of the uterine lining), or endometrial cancer.
Postmenopausal bleeding: Any bleeding that occurs after menopause should be evaluated as it can be a sign of underlying conditions like endometrial atrophy, endometrial polyps, or endometrial cancer. Similar to any abnormal uterine bleeding, you would be asked to undergo a transvaginal ultrasound and determine the endometrial thickness. Any thickness more than 4 mm needs to be evaluated by an endometrial biopsy.
Apart from these reasons around menopause or perimenopause, endometrial biopsies may be done as part of fertility investigations too. They can assess the thickness and receptivity of the endometrium, which is crucial for successful implantation of an embryo.
This procedure can be either done as an outpatient procedure with a small plastic pipelle, or along with an office endoscopy or can also be done as an inpatient, day care procedure along with a curettage of the endometrium.
It's important to note that the need for an endometrial biopsy is determined by your healthcare provider based on your symptoms, medical history, and physical examination. If you have concerns or questions about why you specifically need this procedure, it's best to discuss them with your healthcare provider for personalised information and guidance.