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Endometrial polyps

  • Definition
    • Endometrium is the lining of the inside of the womb (uterus). Overgrowth of this lining can create polyps. Polyps are fingerlike growths that attach to the wall of the uterus. They can be as small as a sesame seed or larger than a golf ball. There may be just one or many polyps.

  • Alternative Names
    • Uterine polyps

  • Causes
    • No one knows exactly why some women get endometrial polyps. They tend to grow when there is more of the hormone estrogen in the body.

      Most endometrial polyps are not cancerous. About 5% can be cancerous or precancerous. The chance of cancer is higher if you are postmenopausal, on Tamoxifen, or have heavy or irregular periods.

      These factors may increase the risk for endometrial polyps:

      • Obesity
      • Tamoxifen, a treatment for breast cancer
      • Postmenopausal hormone replacement therapy
      • Family history of Lynch syndrome or Cowden syndrome (genetic conditions that run in families)
  • Symptoms
    • You may not have any symptoms of endometrial polyps. If you do have symptoms, they may include:

      • Menstrual bleeding that is not regular or predictable
      • Long or heavy menstrual bleeding
      • Bleeding between periods
      • Bleeding from the vagina after menopause
      • Trouble getting or staying pregnant (infertility)
  • Exams and Tests
  • Treatment
    • Most polyps should be removed because of the small possibility of cancer.

      Endometrial polyps are usually removed by a procedure called hysteroscopy. Sometimes, a D and C can be done to biopsy the endometrium and remove the polyp. This is less commonly used.

      Premenopausal women who have no symptoms and no other risk factors could consider watchful waiting. This is when your doctor continues to monitor your health, but does not give treatment unless you have symptoms or something else changes.

  • Outlook (Prognosis)
    • Rarely, polyps can return after treatment.

  • Possible Complications
    • Endometrial polyps may make it hard to get or stay pregnant.

  • When to Contact a Medical Professional
    • Call your health care provider if you have:

      • Menstrual bleeding that is not regular or predictable
      • Long or heavy menstrual bleeding
      • Bleeding between periods
      • Bleeding from the vagina after menopause
  • Prevention
    • You cannot prevent endometrial polyps.

  • References
    • Katz VL. Benign gynecologic lesions: Vulva, vagina, cervix, uterus, oviduct, ovary, ultrasound imaging of pelvic structures. Lentz: Comprehensive Gynecology. 6th ed. Philadelphia, PA: Elsevier Mosby; 2012:chap.18.

      Lieng M, Istre O, Qvigstad E. Treatment of endometrial polyps: a systematic review. Acta Obste Gynecol Scand. 2010:89;992.