Endometrial Polyps

Endometrial polyps are benign overgrowths of endometrial tissue. They can be only a few millimeters in size or grow to be several centimeters. The exact cause of endometrial polyps remains unknown but they seem to be influenced by circulating hormones. Women at an increased risk of developing polyps are obese, have hypertension, have had polyps previously or are taking a medication called Tamoxifen. Tamoxifen is used in the treatment of breast cancer.

Signs and symptoms consist of any abnormal bleeding such as prolonged periods, heavy periods, bleeding in between periods and/or after intercourse, or bleeding/spotting after menopause. Endometrial polyps seldom cause pain but may cause menstrual like cramps.

Endometrial polyps are most often diagnosed by Hysteroscopy. Sometimes, these polyps are visible on ultrasound. Keeping an accurate bleeding diary for 3 months assists clinicians in the diagnosis. When women report any abnormal bleeding, an endometrial biopsy is performed to rule out cancer or abnormal thickening of the lining of the uterus (hyperplasia).

Treatment of endometrial polyps consists of hysteroscopic resection and/or endometrial ablation. Women who wish to maintain their fertility can have the polyps removed surgically (hysteroscopic) whereas women who have completed their childbearing years may choose to have the polyps removed and an endometrial ablation which destroys the endometrial lining completely. Polyps are less likely to re-grow after an ablation. In rare cases, endometrial polyps can be malignant. If a malignant polyp is present the most likely treatment is hysterectomy.

This is a picture of an endometrial polyp on Hysteroscopy.