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Uterine polyps

Uterine polyps (endometrial polyps, intrauterine polyps) are benign overgrowth of endometrium (internal lining of uterus) – finger-like growths that attach to the wall of the uterus. They look soft red and often flatten to fit the cavity of the uterus. Uterine polyps could have short stalk and they vary in size (from few millimeters to several centimeters). Women could have single or multiple polyps.

Uterine polyps – causes and risk groups

Clear cause of uterine polyp is not known but most experts mentioned correlation with increased levels of estrogens (main female hormones). Scientists suggested two theories about appearance of polyps in the uterus. According to first theory, abnormal response to estrogen can stimulate the growth of endometrial tissue. According to second theory, chronic inflammation could trigger irritation and overgrow of endometrium.

Uterine polyp risk groups include women with:

  • Obesity,
  • Hormone replacement therapy (mainly during menopause),
  • Hypertension,
  • Tamoxifen users (breast cancer treatment).

Uterine polyps – symptoms

Sometimes polyps can be asymptomatic (without any symptoms) but most polyps trigger different types of bleeding. It was noted that uterine polyps are responsible for about 25% of all genital bleedings. Most common symptoms include the following:

Uterine polyps

  • Heavy menstrual periods,
  • Irregular menstrual bleeding,
  • Bleeding between periods,
  • Postmenopausal bleeding,
  • Brown spotting between periods,
  • Infertility (uterine polyp that develops near the Fallopian tubes may obstruct the opening of the tubes and lead to infertility).

Uterine polyps – diagnosis

Diagnostic tests could be different in different clinic. Most popular tests include:

  • Hysteroscopy,
  • Hysterography,
  • Transvaginal ultrasound and sonohysterography,
  • Endometrial biopsy,
  • Dilation and Curettage (D&C).

Uterine polyps – treatment

Treatment is pretty simple – once polyp is identified, it should be removed surgically by qualified experts. Histological examination of removed tissues should be done to exclude cancerous cells.

Some experts indicate that polyps under 1cm (without symptoms) can even spontaneously regress without any treatment (especially in postmenopausal women).

Some experts recommend hormonal treatment (gonadotropin-releasing hormone agonists and progestins) for regulation of hormonal imbalances.

Uterine polyps – prognosis

In most cases polyps can be easily removed and/or treated but there is a high probability of recurrence (up to 50% of cases). Very rare polyps can be cancerous or precancerous (about 4-5% of cases). The chance of cancer is higher in postmenopausal women and Tamoxifen users.

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