In most cases, endometrial polyps are benign (non-cancerous), but sometimes they can become malignant (cancerous) or precancerous (likely to become cancerous).
The exact cause of endometrial polyps is not known, but some factors that may increase the risk of developing them are:
Age: Endometrial polyps are more common in women who are 40 years or older, especially those who have gone through menopause.
Hormones: Endometrial polyps may be affected by estrogen, a female hormone that encourages endometrial growth. It is thought that women with high estrogen levels, such as obese, diabetics, or those who receive hormone therapy, are more likely to develop endometrial polyps.
Medications: Tamoxifen, a breast cancer drug, or selective estrogen receptor modulators (SERMs) may increase the likelihood of endometrial polyps developing.
Many women with endometrial polyps do not have any symptoms, and they may not even know they have them. However, some possible symptoms of endometrial polyps are:
Abnormal uterine bleeding: This may include heavy or irregular periods, spotting between periods, or bleeding after menopause.
Infertility: Endometrial polyps may interfere with the implantation of a fertilized egg, making it harder to get pregnant.
Pelvic pain or pressure: Endometrial polyps may cause discomfort or cramping in the lower abdomen, especially during sexual intercourse or bowel movements.
To diagnose endometrial polyps, a doctor may perform one or more of the following tests:
Pelvic exam: The doctor may feel for any abnormalities in the uterus or cervix by inserting two fingers into the vagina and pressing on the lower abdomen with the other hand.
An ultrasound can be done using a probe that emits sound waves to create an image of the uterus and the endometrium on a monitor. This can help detect endometrial polyps.
A thin, flexible tube with a light and camera at the end (called a hysteroscope) can be inserted through the vagina and cervix into the uterus so the doctor can see the endometrium and polyps directly and remove them if necessary.
In an endometrial biopsy, a small sample of the endometrium is removed with a suction device or curette (a sharp, spoon-shaped instrument) and sent to a laboratory for analysis.
There are several possible treatment options for endometrial polyps, depending on the size, number, and nature of the polyps, as well as the woman's symptoms and fertility goals.
If the polyps are small, few, and asymptomatic, and the woman is close to menopause, the doctor may recommend regular ultrasounds and biopsies to monitor changes or signs of cancer.
Medications: The doctor may prescribe hormones, such as progestins or gonadotropin-releasing hormone agonists (GnRH agonists), to shrink or stop the polyps. This is usually a temporary fix, since the polyps may return once the medication is stopped.
Surgery: The doctor may perform a hysteroscopy to remove the polyps with scissors, electrical current, or laser. This is usually done as an outpatient procedure under local or general anesthesia. It is one of the most effective and definitive treatments for endometrial polyps, as it can alleviate the symptoms as well as improve fertility chances.
There is no sure way to prevent endometrial polyps, but some lifestyle changes that may help reduce the risk of developing them are:
Being overweight or obese increases estrogen levels in the body, which stimulates the growth of endometrial polyps. Losing excess weight can help balance hormones and reduce the risk.
In addition to causing inflammation and oxidative stress in the endometrium, diabetes can also increase estrogen levels in the body. Diet, exercise, and medication can help prevent endometrial polyps.
Taking estrogen or estrogen-progestin combinations for menopausal symptoms can increase the risk of endometrial polyps, especially if they are taken long-term or in high doses. It is important that women who need hormone replacement therapy use the lowest effective dose for the shortest time, and see their doctor regularly.
A common and harmless condition, endometrial polyps can sometimes cause problems such as abnormal bleeding, infertility, and cancer. Endometrial polyps can be successfully managed and cured with proper diagnosis and treatment, so it is important to be aware of their signs and symptoms and seek medical attention if they occur.
