Inclusion Criteria:

- Women ages 18 and over who present to the OHSU Center for Women's Health and the
Portland Veteran's Affairs Medical Center with an indication for endometrial biopsy,
are literate in English or Spanish, who are willing to participate in the study.

Exclusion Criteria:

- Pregnancy, known or suspected

- Known cervical stenosis

- History of Mullerian tract anomalies

- History of uterine or cervical surgery

- Pelvic inflammatory disease (current or within the past 3 months)

- Sexually transmitted diseases (current)

- Puerperal or post abortion sepsis (current or within the past 3 months)

- Purulent cervicitis (current)

- Known clotting disorder

- Known uterine anomalies or fibroids distorting the cavity in a way incompatible
with office endometrial biopsy

- Allergy to any component of the Pipelle or Explora curette

- Patients who are premedicated with analgesics or misoprostol

- Patients who require mechanical cervical dilation or receive paracervical block