The procedure begins with the physician placing a speculum in the vagina and viewing the cervix. The cervix is washed with an antiseptic. A thin plastic instrument is passed through the cervix and into the uterus to obtain material that lines the inside of the uterus. This material is the endometrium, which is what a woman sheds with her menses.
Sometimes a physician will place another instrument on the cervix to help straighten the cervix. This eases passage of the biopsy instrument through the cervix.
Endometrial biopsy frequently causes pain similar to a menstrual cramp. I usually ask patients to take ibuprofen, depending on their medical history, one hour before the procedure.
The most common complication from an endometrial biopsy is bleeding after the biopsy. This usually subsides by itself over time. Another complication includes inability to do the biopsy. Occasionally the cervix may be very small. In this case, a dilator may by used to open the cervix to allow passage of the biopsy instrument. If this is unsuccessful the patient may need to have a D&C (dilation and curettage) at a hospital. At the hospital the physician has access to very small dilators and the benefit of good pain control from an anesthesiologist.