Endometrial Polyps

Endometrial polyps are non-cancerous growths attached to the inner lining of the uterus (endometrium). They range in size from a few millimetres to several centimetres and are most common in women aged 40–50 or those on hormone therapy. Most are benign, but evaluation is key to rule out rare cancerous changes.

Common Symptoms

Many polyps cause no symptoms. When present, symptoms may include:

• Irregular menstrual bleeding (between periods).
• Heavy or prolonged periods (menorrhagia).
• Bleeding after menopause.
• Difficulty conceiving (infertility or recurrent miscarriages).

Causes & Risk Factors

• Hormonal imbalance: Excess oestrogen relative to progesterone.
• Age: More common in perimenopausal and postmenopausal women.
• Medications: Tamoxifen (breast cancer treatment) or long-term hormone therapy.
• Obesity: Fat tissue can produce excess oestrogen.

Diagnosis

1. Transvaginal ultrasound: Checks for uterine abnormalities.
2. Hysteroscopy: A thin camera inserted into the uterus to view polyps directly.
3. Biopsy: Tissue sample taken to rule out cancer (rarely needed).

Treatment Options

1. Watchful Waiting: Small, asymptomatic polyps may resolve on their own.
2. Medications:
   1. Hormonal therapies (progestins, birth control pills) to regulate bleeding.
3. Surgical Removal:
   1. Hysteroscopic polypectomy: Minimally invasive procedure to remove polyps.

Frequently Asked Questions

Q: Are polyps cancerous?
A: Most are benign, but 1–5% may have cancerous changes, especially in postmenopausal women.

Q: Can polyps recur?
A: Yes, recurrence is possible. Regular follow-ups are advised if symptoms return.

Q: Is surgery risky?
A: Hysteroscopy is low risk, with minor complications like light bleeding or infection.

Q: Do polyps cause pain?
A: Rarely, but large polyps may cause cramping.

eGynaecologist Advice:

• Most polyps are harmless but should be evaluated by your gynaecologist for treatment and follow up care.
• Removal of endometrial polyp is recommended for symptomatic polyps, polyps in postmenopausal women, or if cancer is suspected. You should seek gynaecological consultation to plan your treatment
• You should seek gynaecological consultation if you are planning pregnancy and have been found to have polyp as these may interfere with implantation and removal often improves fertility outcomes.
• You must seek urgent gynaecological consultation if you develop post-menopausal bleeding or heavy bleeding leading to fatigue or anaemia