Endometrial biopsies are medical procedures that involve removing a small piece of the tissue within the endometrium, also known as the uterine lining, for examination. It is used to check for cell abnormalities or cancer. Doctors suggest endometrial biopsies to determine the cause of irregular or heavy bleeding. It is the most common test for diagnosing endometrial cancer. The procedure should only take five to fifteen minutes. Some slight bleeding is usually nothing to be concerned about after endometrial biopsy.

Is It Normal to Have Bleeding After Endometrial Biopsy?

For several days following your procedure, you may notice some vaginal bleeding or spotting. Although small amounts of bleeding are normal after endometrial biopsy, you should tell your doctor if the bleeding lasts for more than two days following the procedure or is excessive.

Tips for Aftercare

• Your health care provider will likely suggest you take a pain reliever, but only take the type they recommend. Certain over-the-counter medications like aspirin can increase your risk of bleeding.
• For the two to three days following the endometrial biopsy, do not use tampons, have sex, or douche. Your doctor may recommend you wait longer than this to engage in these activities.
• Your physician may also suggest you avoid heavy lifting or strenuous activity following the procedure.

Experiences About Bleeding After Endometrial Biopsy

• “I have undergone two endometrial biopsies. The first one wasn’t unpleasant or uncomfortable and I’m not sure if this is because my lining was 18 mm which is considered thick. The more recent one last year bothered me a bit. I bled for a few days afterwards. Since then, I’ve learned that the best method for dealing with endo biopsies is taking some Advil, Motrin, or Tylenol about an hour before the procedure is scheduled.”
• “My endometrial biopsy was a week ago and I’ve never had kids. The doctor opened my cervix using a sound before inserting the collection tube. I felt pain during the procedure. It felt as if a hot knife was stabbing my abdomen and it lasted during both the sounding and collection. I then had abdominal pain for a few days. During the procedure, I had some bleeding and spotting. Afterwards, this bleeding continued for seven days. The procedure shouldn’t have caused prolonged bleeding, but I’ve seen many women notice it. I feel that the standard description of the procedure isn’t accurate and doesn’t show people’s actual experiences. I still don’t have my biopsy results so I don’t know whether cancerous growths caused this bleeding and pain.”
• “I bled before my endometrial biopsy but bled more following it. Eventually, it didn’t feel so bad, but I was diagnosed with uterine cancer in stage 1C. I already had my hysterectomy and will be starting radiation soon.”

More Reasons for Abnormal Vaginal Bleeding

Your bleeding may not be directly caused by endometrial biopsy, and it may have something to do with other conditions. Here are more possible reasons for bleeding after endometrial biopsy.

• Women who are getting close to menopause may notice dysfunctional bleeding from their hormonal changes.
• Noncancerous sores such as lesions or polyps on the genitals can lead to bleeding. Various cancers can cause it as well, including that of the ovaries, vagina, uterus, and cervix. Those with cervicitis, fibroids, ovarian cysts, endometritis, and vaginal infections may also experience excessive bleeding. Those over 50 or after menopause should especially be concerned about vaginal bleeding since the cancer risk increases as we age.
• Another reason for abnormal bleeding of the vagina would be trauma. This can be due to sexual intercourse. Certain IUDs can lead to heavier periods as well. Older women may experience bleeding after or during sexual intercourse since the lack of estrogen may make the vaginal walls dry.
• Some drugs can lead to bleeding, particularly if you are also on anticoagulants.
• There are also certain bleeding disorders which are inherited, such as hemophilia and von Willebrand disease that can lead to prolonged or excessive vaginal bleeding.  

Other Complications of Endometrial Biopsy

1. Prolonged Pain

During the actual procedure, you may notice some mild cramping. In most cases, this pain will be completely manageable with the help of over-the-counter medications and will go away quickly after the procedure is done.

2. Pelvic Infection

Except pain and bleeding after endometrial biopsy, in rare cases, a patient may experience a pelvic infection, either of their uterine tubes or the uterus itself following this procedure. Watch out for symptoms of a potential infection, including fever, chills, foul-smelling discharge from the vagina, and severe pain in the lower abdomen. Your doctor will suggest antibiotics to treat an infection.

3. Perforation

Rarely the biopsy device will cause a puncture on the uterine wall, which creates a tiny hole within the organ. When this occurs, the procedure will be stopped. You may experience increased pain over the following 24 hours, but you should still be able to go back to normal activities on the following day. In extremely rare cases, the patient will have signs of blood loss, fever, or excessive pain. These symptoms need to be reported immediately to your doctor. The hole should heal within several weeks and the procedure can be performed again. Although rare, perforation is more likely to happen if a woman has a more constricted uterine opening or recently gave birth.