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Concierge gynaecology · London

Endometrial biopsy, Pipelle sampling and hysteroscopic biopsy for postmenopausal bleeding and abnormal cycles.

An endometrial biopsy samples the lining of the uterus to investigate postmenopausal bleeding, heavy menstrual bleeding and abnormal endometrium on scan. Options include Pipelle biopsy in clinic or hysteroscopic biopsy under sedation / GA.

See indicative pricing
A gynaecologist performing an endometrial biopsy in a private London clinic

Why patients choose us

  • 01

    The right hands

    We route you to a consultant gynaecologist experienced in Pipelle and hysteroscopic biopsy — the person who samples you also reads the story.

  • 02

    Often answers same-day

    Immediate impressions after the procedure; histology in 7–10 days with a clear next step.

  • 03

    Independent, and free

    We are paid by no clinic, so the recommendation is impartial and costs you nothing.

Indicative pricing

What a private endometrial biopsy costs in London.

Indicative ranges across our partner clinics. Send the details and we quote firm figures across two or three options.

In short

A Pipelle biopsy in clinic: £350–£650, histology in 7–10 days.

Biopsy type Indicative range
Pipelle endometrial biopsy in clinic £350–£650
One-stop postmenopausal bleeding clinic (US + Pipelle) £650–£1,200
Outpatient hysteroscopy + directed biopsy £1,400–£2,400
Hysteroscopic biopsy under GA / sedation £2,600–£4,500
Polypectomy at hysteroscopy £2,800–£4,800
Urgent 2-week pathway (suspected cancer) £800–£1,500

Prices vary by clinic, whether same-visit ultrasound is added, and whether the biopsy is done under local, sedation or general anaesthetic. We come back with a firm quote within one working day.

The problem

An endometrial biopsy is only as good as who takes and reads it.

The histology is the answer — and the gynaecologist who samples and the pathologist who reports decide the next step. We route you to a consultant gynaecologist experienced in outpatient hysteroscopy, not a generalist.

  • Postmenopausal bleeding?

    We arrange same- or next-day one-stop assessment with ultrasound and Pipelle.

  • Heavy or irregular periods?

    We work up structural and endometrial causes together, in a single visit.

  • Thickened endometrium on scan?

    We fold the biopsy into a full gynae work-up — imaging, histology, plan.

The journey

From consultation to histology — what happens, in order.

One gynaecologist from first consultation to result — often within days.

  1. 01

    Before

    Gynaecology / one-stop consultation

    A confidential consultation to review symptoms, prior scans, medications (HRT, tamoxifen) and family history.

  2. 02

    Before

    Ideally day 1–10 of cycle if pre-menopausal

    Timing improves sampling quality and reduces false-negatives from secretory endometrium.

  3. 03

    Before

    Analgesia 30 min pre-procedure

    Simple oral analgesia settles cramping. You can eat and drink normally.

  4. 04

    On the day

    Speculum insertion

    A gentle speculum examination to visualise the cervix — no different from a smear.

  5. 05

    On the day

    Pipelle passed into uterine cavity

    A thin flexible catheter (3 mm) is passed through the cervix into the uterine cavity.

  6. 06

    On the day

    Aspiration sample taken

    The Pipelle aspirates a strip of endometrial tissue. Cramping lasts under a minute.

  7. 07

    After

    Histology in 7–10 days

    A written report from the reporting pathologist with the concrete next step.

Typical end-to-end: 7–14 days. Urgent 2-week pathway: available.

What it shows

When an endometrial biopsy is the right test.

The biopsy answers a specific question — what is happening in the lining of the uterus, and does it explain the bleeding. These are the histology categories we see most.

  • Endometrial hyperplasia

    Thickened endometrium without atypia — the commonest abnormal finding, usually treated medically.

  • Endometrial polyp

    A focal lesion that needs hysteroscopic removal for definitive histology.

  • Endometrial atrophy (postmenopausal)

    A thin, quiescent lining — the commonest cause of postmenopausal bleeding.

  • Endometrial adenocarcinoma

    The diagnosis Pipelle is designed to catch — triggers urgent gynae-oncology MDT.

  • Atypical hyperplasia

    A pre-cancerous change with significant progression risk — hysterectomy usually discussed.

  • Chronic endometritis

    Persistent low-grade inflammation, relevant to fertility and abnormal bleeding.

  • Insufficient sample

    Common in atrophic endometrium — hysteroscopy is the next step when clinically indicated.

  • Red flag: atypical hyperplasia or adenocarcinoma — urgent gynae-oncology MDT

    These findings are discussed at the next MDT and staging is arranged without delay.

Biopsy types

Not all endometrial biopsies are the same.

What each option on your referral is actually for.

  • Pipelle biopsy in clinic

    Walk-in, walk-out sampling with a 3 mm flexible catheter — 10 minutes, no anaesthetic.

  • One-stop PMB clinic

    Transvaginal ultrasound plus Pipelle in a single visit for postmenopausal bleeding.

  • Outpatient hysteroscopy

    A slim camera passed through the cervix under local anaesthetic, with directed biopsy of focal lesions.

  • Hysteroscopy under GA / sedation

    For failed outpatient sampling, cervical stenosis, or when the patient prefers to be asleep.

  • Polypectomy at hysteroscopy

    Removal of endometrial polyps under direct vision — sent whole to the pathologist.

  • Suspected-cancer pathway

    Expedited assessment when scan or symptoms raise concern for endometrial malignancy.

  • Tamoxifen surveillance sampling

    Focused biopsy for endometrial change on long-term tamoxifen therapy.

  • Lynch-syndrome screening biopsy

    Structured endometrial sampling in confirmed Lynch families as part of cancer surveillance.

Our vetted London network

A small panel of clinics, we picked them.

Partners across central, north, west and south London. Not listed publicly — introductions are made privately, once we understand your case.

Selection criteria

How we choose every clinic in our network.

A modern London gynaecology suite equipped for outpatient hysteroscopy and endometrial biopsy
Consultant gynaecologists
  • Consultant gynaecologists with subspecialty interest in outpatient hysteroscopy and colposcopy

  • Same-visit ultrasound and Pipelle where a one-stop pathway is appropriate

  • BSGE-standard hysteroscopy suites for outpatient and day-case procedures

  • Onward gynae-oncology MDT pathway if hyperplasia with atypia or cancer is found

Safety and eligibility

A safe, well-established outpatient procedure.

Pipelle biopsy is well tolerated by the majority of women, with a small but real set of practical points around timing, analgesia, and when to escalate to hysteroscopy.

  • Painless most of the time

    Cramping is brief — most women rate a Pipelle at 3–4 out of 10 for under a minute.

  • Uterine perforation is rare

    Perforation is reported in under 1 in 1,000 outpatient Pipelle procedures and usually needs no treatment.

  • Post-procedure infection

    Very uncommon — offensive discharge, fever or worsening pain warrants a same-day review.

  • Analgesia in advance

    Paracetamol and ibuprofen 30 minutes before the biopsy makes a real difference.

  • Timing in the cycle

    Days 1–10 of the cycle give the clearest histology if you are pre-menopausal.

  • Failed Pipelle in a cancer worry

    If Pipelle fails and the concern is cancer, hysteroscopy is arranged — not repeat Pipelle.

  • Tamoxifen changes

    Tamoxifen produces benign endometrial changes; sampling is only for bleeding, not routine surveillance.

  • Bring prior imaging and cytology

    Recent transvaginal ultrasound and smear history sharpen the report meaningfully.

  • Postmenopausal bleeding is a red flag

    Any bleeding after the menopause needs prompt gynaecology assessment — do not delay.

Reading your report

A histology report can look intimidating. It isn’t.

Whatever the finding, the report keeps to the same four parts.

A consultant gynaecologist reviewing endometrial histology on a clinical workstation at a UK private clinic

A quiet reminder

The report is written for your doctor, not for you — and that’s normal.

If you would like us to talk you through it before your follow-up, just ask.

  1. 01 Header

    Indication and clinical context

    Your details, indication for biopsy, cycle day, HRT / tamoxifen use and relevant family history.

  2. 02 Technique

    Pipelle or hysteroscopic sampling

    Which route was used, tolerability, and whether the sample was adequate for full histological assessment.

  3. 03 Findings

    Histology of the endometrium

    Description of the endometrium — proliferative, secretory, atrophic, hyperplasia (with or without atypia), or malignancy.

  4. 04 Impression

    The conclusion: read this first

    Normal, benign, hyperplasia, or cancer — and the concrete next step, whether reassurance, IUS, hysteroscopy or MDT.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Cover depends on your policy and clinic; we confirm with your insurer before booking.

Frequently asked

Everything we get asked about endometrial biopsy.

Quick answers on cost, pain, referrals, when hysteroscopy is needed and how long results take.

  • What does an endometrial biopsy show?

    It samples the lining of the uterus (endometrium) for histology — showing normal cyclical endometrium, atrophy, polyps, hyperplasia with or without atypia, or endometrial cancer. It is the gold-standard test for diagnosing endometrial cancer.

  • Is a Pipelle biopsy painful?

    Most women describe brief cramping lasting under a minute, rated 3–4 out of 10. Taking paracetamol and ibuprofen 30 minutes beforehand helps significantly. If sampling has previously been difficult or painful, hysteroscopy under sedation is an option.

  • How much does a private endometrial biopsy cost in London?

    A Pipelle biopsy in clinic is typically £350–£650 in our network; a one-stop postmenopausal-bleeding clinic with ultrasound sits at £650–£1,200. Hysteroscopic biopsy under GA is £2,600–£4,500. We confirm firm figures within one working day.

  • Do I need a referral?

    Most clinics accept self-referral. We can arrange a fast-track private GP or gynaecology consultation if a formal referral is needed for insurance or the onward pathway.

  • When would I need hysteroscopy instead of a Pipelle?

    When a focal lesion (polyp, fibroid) is seen on scan, when the Pipelle sample is insufficient, when cervical stenosis prevents sampling, or when suspicion of cancer is high and the Pipelle has failed. Hysteroscopy allows directed biopsy under vision.

  • How quickly will I get results?

    The clinician usually shares initial impressions immediately after the procedure. Histology from the pathologist follows in 7–10 days, with a same-day call from us as soon as the result is available.

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In practice, in London

The London pathway for endometrial biopsy

With endometrial biopsy, the London question is usually about report turnaround and the radiologist reading it — not whether the scan is available. The NHS route for endometrial biopsy is thorough, but the queue is real. Most patients we speak with have been told to expect anywhere from a handful of weeks to several months, depending on their local trust and how the referral is graded. Going private in London usually collapses that window to a matter of days — often the same week if the diary allows. It isn’t about jumping a queue so much as buying time back while you still have the flexibility to plan around it.

The mechanics are straightforward: a consultant appointment, any tests done at a nearby CQC-registered site, and a written report back within a few days. London’s density of private diagnostics — Marylebone, the City, Chelsea, Canary Wharf — means most patients can find something that fits around work without a cross-town trek. For endometrial biopsy specifically, the difference between a routine report and a sub-speciality read is where private care earns its keep.

We’re careful about what a private pathway for endometrial biopsy can and can’t promise. It can compress a wait, put you in front of a subspecialist quickly, and get a proper report in your hands within a week. It can’t rewrite what the imaging or the bloods say. Setting that expectation up front tends to make the whole experience less stressful.

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