Indications for endometrial biopsy

Question 1

Indications for endometrial biopsy

Answer 1

1. Sinister symptoms
   a. Intermenstrual bleeding
   - Woman > 40yo
   - Persistent (in woman <40yo)
   b. Postmenopausal bleeding
2. Risk factors for endometrial ca
   - >45yo
   - PCOS
   - Obesity
   - Unopposed estrogen treatment
   - Treatment failure with hormones
3. Abnormal U/S findings
   a. Thickened endometrium lining
   Post-menopausal: >5mm
   b. Pre-menopausal: >15mm during all times of menstrual cycle
   c. Polyp >1.5mm (Big) or symptomatic (AUB) –> Consider D&C to remove for biopsy
4. Abnormal PAP smear
   - Endometrial cells
   - Glandular cells