If a 41-year-old had uterine bleeding for ~3 years but has since been having a regular menstrual cycle for 7 months, is endo biopsy still necessary?

I would still do it. I would still do the endometrial biopsy. Its a 2 minute procedure and is a very good way to make sure there isn't any cancer or pre-cancer in the uterus. I think it is better to do the biopsy than to miss a uterine cancer or worry about a uterine cancer. Get it done. You and your doctor will both sleep better! Best wishes!