The following are indications for endometrial biopsy. Click on each indication for a more complete discussion.

1. Abnormal vaginal bleeding
• Causes of abnormal bleeding
2. Infertility
3. Suspected endometritis
4. Abnormal Pap smear:
• Atypical or malignant endometrial cells are noted on cervical cytology
• Normal endometrial cells are detected on cervical cytology in a postmenopausal woman
5. Abnormal ultrasound:
• Thickened endometrial stripe
• A fluid collection in the cavity of the uterus in a postmenopausal woman
6. A woman taking tamoxifen with abnormal bleeding or an abnormal ultrasound

The use of endometrial biopsy for routine screening for endometrial cancer is probably not indicated in asymptomatic women. Routine endometrial biopsy immediately before hysterectomy is also probably not indicated.

Serial endometrial biopsies may be necessary to follow a patient with known endometrial hyperplasia.