Endometrial biopsy in AUB is indicated in which scenario?

Endometrial biopsy in AUB is indicated in which scenario?

• A. Adolescents with AUB
• B. Women with regular cycles
• C. Postmenopausal women with no bleeding
• D. Women over 45 with AUB

Answer: (D)

Endometrial sampling is most warranted when there is a meaningful risk of endometrial pathology, especially cancer or hyperplasia, which increases with age. In someone over 45 who presents with abnormal uterine bleeding, an endometrial biopsy is indicated to rule out endometrial cancer or precancerous changes and to guide further management. In younger adolescents, AUB is usually due to anovulatory cycles from immaturity of the hypothalamic-pituitary-ovarian axis, so biopsy is not routinely needed. When cycles are regular, AUB often reflects functional hormonal disruption rather than endometrial disease, so biopsy isn’t routinely indicated either. A postmenopausal person with no bleeding has no bleeding-related indication for endometrial sampling.

Endometrial sampling is most warranted when there is a meaningful risk of endometrial pathology, especially cancer or hyperplasia, which increases with age. In someone over 45 who presents with abnormal uterine bleeding, an endometrial biopsy is indicated to rule out endometrial cancer or precancerous changes and to guide further management. In younger adolescents, AUB is usually due to anovulatory cycles from immaturity of the hypothalamic-pituitary-ovarian axis, so biopsy is not routinely needed. When cycles are regular, AUB often reflects functional hormonal disruption rather than endometrial disease, so biopsy isn’t routinely indicated either. A postmenopausal person with no bleeding has no bleeding-related indication for endometrial sampling.