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Complications of an Endometrial Biopsy

author image Robyn Hughes
Robyn Hughes has been writing since 2008 about health, nutrition, fitness and botanical medicine. She is a naturopathic physician and freelance writer based in Durham, N.C. She holds a Bachelor of Arts in cognitive science from Indiana University and a doctoral degree from the National College of Natural Medicine in Portland, Ore.
Complications of an Endometrial Biopsy
Medical technician looking through a microscope Photo Credit: AlexRaths/iStock/Getty Images

When a woman experiences abnormal uterine bleeding or infertility, her doctor may recommend an endometrial biopsy. Endometrial biopsy is an outpatient procedure that enables evaluation of the uterine lining. A small catheter is inserted into the uterus through the vagina in order to extract a sample of the tissue. This sample is analyzed under a microscope to check for cancerous or pre-cancerous cells or other abnormalities. Endometrial biopsy is generally safe, but on rare occasions, complications occur.

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Prolonged Pain or Bleeding

During an endometrial biopsy, a woman may experience mild cramping. The pain can be managed with over-the-counter medications and typically resolves shortly after the procedure. After the procedure, it also is normal for some bleeding to occur. Occasionally, however, the pain or bleeding becomes excessive. If the pain lasts more than two days or the bleeding is more than a normal menstrual flow, the patient should contact her doctor.

Pelvic Infection

Infection of the uterus or uterine tubes infrequently results from endometrial biopsy. Symptoms that suggest infection include foul-smelling vaginal discharge, fever, chills and severe lower abdominal pain. If these occur, the patient will require antibiotics and a doctor should be contacted.


On rare occasions, the biopsy device can puncture the wall of the uterus, creating a small hole in the organ, according to American Family Physician. If this happens, the procedure will be discontinued. The patient may experience some increased pain for the next 24 hours, but she should be able to return to normal activities the next day. Very rarely, she may experience excessive pain, fever or signs of blood loss, which should be reported to her doctor. The hole typically heals within a few weeks, after which point the procedure may be repeated. Uterine perforation is unusual, but it is more likely to occur if a woman has recently had a baby or if the uterine opening is more constricted than normal.

Pregnancy Damage

Because it involves tampering with the womb, endometrial biopsy can damage an existing pregnancy. For that reason, if a woman suspects she is pregnant, she should alert her doctor and inquire about alternative forms of evaluation. To make sure a patient isn’t pregnant, many doctors administer a pregnancy test prior to performing an endometrial biopsy.

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